Bladder Reconstruction Using Bowel Segments

Joseph B. Abdelmalak; Sandip P. Vasavada; Raymond R. Rackley

doi:10.1055/s-2003-39037

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Clin Colon Rectal Surg 2003; 16(1): 051-060
DOI: 10.1055/s-2003-39037

Bladder Reconstruction Using Bowel Segments

Joseph B. Abdelmalak, Sandip P. Vasavada, Raymond R. Rackley

Section of Voiding Dysfunction and Female Urology, Cleveland Clinic Foundation, Cleveland, Ohio

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Publication Date:
07 May 2003 (online)

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ABSTRACT

Enterocystoplasty is a feasible and successful technique for creating a compliant and large-capacity storage unit. It protects the upper urinary tract and provides urinary continence for people with bladder dysfunction caused by noncompliance or reduced functional capacity when more conservative management fails. Augmentation cystoplasty has a significant clinical improvement on bladder control without a negative impact on bowel control. Various bowel segments can be fashioned and anastomosed to the bladder; however, no bowel segment is a physiologic substitute for a native bladder. All have the potential for a variety of complications including urinary tract infection, stone and mucus formation, small bowel obstruction, metabolic complications, fistula formation, and malignancy transformation. The choice of the bowel segment is based on the primary clinical requirements of the patient and the secondary preference of the surgeons. The technical steps in performing a laparoscopic bladder augmentation are designed to emulate its open surgical counterpart in every aspect, thereby producing similar functional results with an improved recovery.

KEYWORDS

Augmentation - cystoplasty - incontinence - diversion

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