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Abstract
Purpose
We evaluated the long-term outcomes in patients undergoing augmentation ileocystoplasty with Goodwin’s ileal cup patched bladder.
Materials and Methods
This was a retrospective study of 72 consecutive patients who underwent augmentation ileocystoplasty because of decreased bladder capacity, vesico-ureteral reflux and urinary incontinence. The outcomes assessed included the continence status, bladder capacity, upper tract status, and significant post-operative complications.
Results
The 72 patients studied (61 men and 11 women) were 12 to 62 years old (mean age 35.6). The follow up was 0.3 to 7.9 years (mean 5.4). The preoperative diagnoses were a neurogenic bladder from spinal cord injury in 54 patients, meningomyelocele in 5, pelvic trauma in 3, poly-myelitis in 2, GU tuberculosis in 2, cerebrovascular diseases in 2, and disc rupture in 2. The bladder capacity was significantly increased from 168cc to 392cc postoperatively and the maximal bladder capacity was increased along with the decreased number of daily clean intermittent cathe-terizations. The most common complication related to surgery was a paralytic ileus. While most cases of unilateral reflux disappeared, bilateral or high grade reflux remained during the postoperative follow up period.
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Fig. 1.
The flat patch of the ileum formed is pulled together in the form of a U shape and sutured together with a continuous, intermittently locking catgut sutures. After the peritoneum has been mobilized from the base of the bladder, the bladder is opened in the midline, through its vertex. The ileac patch is then sewed to the bladder beginning posterior in the midline and working laterally from each side using a continuous catgut sutures.
Table 1.
Clinical characteristics of the patients
Table 2.
Preoperative complication and vesicoureteral reflux
Table 3.
Surgical outcomes
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