title: Ureterocystoplasty: an ideal method for vesical augmentation in children.
abstract: BACKGROUND
  Inadequate therapy endangers upper urinary tract function in children with low compliance bladders. We report our approach of increasing bladder compliance using the patients own (mega)-ureter for bladder augmentation.
  
  
  METHODS
  A total of 8 children underwent ureterocystoplasty. The etiology of bladder non-compliance and the need for augmentation was neurogenic in 5 children, posterior urethral valves in 2 children and in one child the situation after repeated antireflux surgery. In all patients the kidney of the used ureter was functionless. Surgery was done through a transperitoneal approach. After nephrectomy, the renal pelvis and the ureter were spatulated and sutured into the bladder incision. An additional MACE stoma was made in 3 patients, antireflux surgery for the contralateral kidney was necessary in 2 patients and one patient underwent stone removal in the remaining kidney. In 1 patient the ureter was used as a free transplant and was covered by an omental flap. In addition, a simultaneous living donor kidney transplant was performed (case 2).
  
  
  RESULTS
  Bladder capacity and compliance improved significantly in all patients. The function of the ureter which was used as a free transplant showed good clinical results. The longest follow-up is 8 years.
  
  
  CONCLUSIONS
  Ureterocystoplasty is a useful and metabolically neutral alternative to bowel segments. In patients with only one functioning kidney and a contralateral megaureter, ureterocystoplasty is the treatment of choice in our institution.
authors.affiliation: University of Bonn, Department of Urology, Bonn, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Fisang
authors.forename: S
authors.initials: S
authors.lastname: Hauser
authors.forename: S C
authors.initials: SC
authors.lastname: Müller
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003187:Compliance; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D009392:Nephrectomy; D011183:Postoperative Complications / Q000601:surgery; D012086:Reoperation; D013524:Surgical Flaps; D014513:Ureter / Q000601:surgery*; D014521:Urethra / Q000002:abnormalities*; D014525:Urethral Stricture / Q000151:congenital / Q000601:surgery*; D001743:Urinary Bladder / Q000601:surgery*; D001750:Urinary Bladder, Neurogenic / Q000601:surgery*; D016476:Urinary Reservoirs, Continent; D014563:Urodynamics / Q000502:physiology; D013520:Urologic Surgical Procedures / Q000379:methods*; D014718:Vesico-Ureteral Reflux / Q000601:surgery*