Abstract
Augmentation cystoplasty (AC) is a surgical procedure for patients with refractory neurogenic bladder (NB). This study aimed to evaluate urinary incontinence (UI), vesicoureteral reflux (VUR), and urodynamic parameters in patients’ post-AC and compare these results to preoperative data.
Methods: In this retrospective cohort study, 42 consecutive patients with refractory NB underwent AC between February 2009 and March 2023, with a minimum follow-up of one year. Evaluated parameters included UI, VUR, maximum cystometric capacity (MCC), expected bladder capacity (EBC), bladder compliance, and end-filling detrusor pressure (EFP).
Results: Among 22 eligible patients (50% male, median age 12 years), 77.3% underwent ileocystoplasty with Mitrofanoff. Preoperatively, UI was diagnosed in 81.8% of patients, with complete resolution observed in 83.3% post-AC (p<0.001). Preoperative VUR was present in 31.8% of patients, and post-AC, high-grade VUR resolved in 90.9–100% (p=0.001). Median MCC increased from 120 mL to 405 mL (p<0.001), with EBC normalizing in 85.7% of cases (p<0.001). Bladder compliance improved from 6.4 to 38.3 mL/cmH?O (p<0.001), while median end-filling detrusor pressure decreased from 20.0 to 11.0 cmH?O (p<0.001).
Conclusions: After AC, children and adolescents with refractory NB showed significant improvement in UI, VUR, MCC/EBC, bladder compliance, and EFP.
Keywords
Augmentation cystoplasty, Neurogenic bladder, Urinary incontinence, Vesicoureteral reflux, Urodynamics