Nonsecretory intestinocystoplasty: a 10-year experience.
OBJECTIVE
We present long-term results on the use of demucosalized intestine for reconstructive surgery of the bladder.


METHODS
A total of 129 bladder augmentations with demucosalized intestine were performed in 123 patients (55% males and 45% females) 3 months to 53 years old during the last 10 years. Of the patients 82 presented with neurogenic bladder, 40 with bladder exstrophy, 3 each with tuberculosis and posterior urethral valves, and 1 with female hypospadias. Sigmoid was used in 104 cases and ileum in 25. In 105 cases a silicone balloon was left inside the augmented bladder for 2 weeks. In the remaining cases bladder mucosa was preserved and no mold was used. A silicone inflatable bladder neck cuff was implanted at the same time as augmentation in 32 patients.


RESULTS
Followup ranged from 3 to 135 months (median 51.0). There was a 329% increase in bladder capacity and compliance increased 7-fold. There were 13 (10.1%) cases considered failures, which were treated with reaugmentation using demucosalized ileum (6), different forms of augmentation (5) and no reaugmentation (2). There was no mucus formation, bladder perforation or neoplasia.


CONCLUSIONS
Based on our study we conclude that demucosalized intestine is a safe alternative for bladder augmentation and can be used for the same indications as total bowel segments.
Lima
Salvador Vilar C
SV
Hospital das Clínicas, Federal University of Pernambuco and Hospital Infantil Manoel Almeida, Recife, Brazil.
Araújo
Luiz Alberto P
LA
Vilar
Fabio O
FO
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D012809:Colon, Sigmoid / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000637:transplantation*; D007223:Infant; D007413:Intestinal Mucosa / Q000601:surgery; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D001743:Urinary Bladder / Q000601:surgery*; D001745:Urinary Bladder Diseases / Q000601:surgery*; D014549:Urinary Incontinence / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*