Long-term risks of bladder augmentation in pediatric patients.
OBJECTIVE
Bladder augmentation is still a commonly performed reconstructive procedure for pediatric patients with severe bladder dysfunction. Recent developments in the long-term risks associated with this procedure are reviewed.


RESULTS
There are metabolic changes in these patients after incorporation of bowel into the urinary tract. Linear growth and bone mineral density are more affected by the primary disorder rather than bladder augmentation. There is a high rate of reoperation in patients after bladder augmentation for perforation, bladder stones, and bowel obstruction. Bladder cancer has been reported in patients after bladder augmentation but also in patients without augmentation.


CONCLUSIONS
Bladder augmentation is associated with a number of potential long-term risks, including a high risk of needing further surgery and development of serious complications such as bowel obstruction or bladder perforation. Bladder stones continue to be common in patients after bladder augmentation. Multiple cases of bladder cancer have been reported recently in young adults with a history of bladder augmentation in childhood and reinforce the need for lifelong follow up for these patients. Future studies will hopefully define the benefits and role of cancer surveillance for these patients.
Department of Urology, University of Iowa, Iowa City 52242-1089, USA. chris-austin@uiowa.edu
J Christopher
JC
Austin
D002648:Child; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology; D008659:Metabolic Diseases / Q000209:etiology; D012086:Reoperation; D001745:Urinary Bladder Diseases / Q000209:etiology / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects*