title: [Growing up with a bladder augmentation].
abstract: BACKGROUND
  This study assesses long-term outcome of patients with neuropatic bladders who underwent a bladder augmentation before puberty.
  
  
  METHODS
  A total of 21 patients with low compliant neuropathic bladders who did not respond satisfactory to clean intermittent catheterization and/or anticholinergic therapy underwent bladder augmentation (mean age 8.3 yr, range; 2.5-12). Eighteen patients (86%) had VUR and/or ureterohydronephrosis and 17 (81%) had DMSA renal scars. Renal function was normal in all cases except one. All patients were followed at regular intervals with serum electrolyte and creatinine determination, urinary tract imaging, urodynamic evaluation and 24-hour urine collection. In the 18 cases augmented with intestine, urine cytology, cystoscopy and biopsy were also performed.
  
  
  RESULTS
  Mean follow-up was 11 yr (8-14.5) and mean age at the end of follow-up was 19 yr (13.3-26.8). Urodynamic studies showed a significant improvement in bladder compliance. Upper urinary tract dilatation disappeared in all patients, VUR in 13/15p (86%) and no new renal scarring occurred. Renal function was normal at the end of follow-up in 20. Only 1 patient had UTI and another had a bladder stone. All patients are dry and 2 of them do not need clean intermittent catheterization. Urine cytology and cystoscopy were normal and no malignat lessions have been found in the biopsy specimens.
  
  
  CONCLUSIONS
  Bladder augmentation done pre-puberty preserves renal function and resolves VUR and/or hydronephrosis in most cases without reimplanting the ureters. Close lifelong follow-up, including a cystoscopy, improves the results and prevents complications.
authors: Departamento de Urología Pediátrica, Hospital Infantil La Paz, Madrid.
authors: P
authors: P
authors: López Pereira
authors: L
authors: L
authors: Espinosa
authors: J A
authors: JA
authors: Moreno Valle
authors: J M
authors: JM
authors: Alonso Dorrego
authors: L
authors: L
authors: Burgos Lucena
authors: M J
authors: MJ
authors: Martínez Urrutia
authors: R
authors: R
authors: Lobato Romera
authors: M
authors: M
authors: Luz Picazo
authors: A
authors: A
authors: Caminoa
authors: E
authors: E
authors: Jaureguízar Monereo
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007422:Intestines / Q000637:transplantation; D008297:Male; D012189:Retrospective Studies; D001750:Urinary Bladder, Neurogenic / Q000601:surgery*