Reconstructive surgery for tuberculous contracted bladder: experience of a center in northern India.
OBJECTIVE
To document the management of tuberculous cicatrized urinary bladder by incorporating bowel segment and the long-term follow-up after the reconstructive surgery.


METHODS
Twenty-three patients (out of 28) were managed by augmentation cystoplasty (AC) and 5 by orthotopic neobladder (OTN) reconstruction. Sigmoidocystoplasty was performed in 11 cases, ileocystoplasty in 10 patients and ileocecocystoplasty in 2 patients. Ileal neobladder reconstruction was done in 2 patients, ileocecal neobladder reconstruction in 1 patient and sigmoid neobladder reconstruction in 2 patients, respectively. The patients were followed according to standard follow-up protocols.


RESULTS
The mean age of patients who underwent AC was 32.5 years and of those who underwent OTN reconstruction was 31 years. The mean pre-operative bladder capacity in patients with AC was 70 ml (range 40-100 ml) and of patients with OTN reconstruction was 14 ml (range 10-20 ml). The mean postoperative bladder capacity at 3 months following AC was 427 ml (range 450-500 ml) and following OTN reconstruction it was 430 ml (range 350-450 ml). The mean follow-up in patients who underwent AC was 43.3 months (range 12-90 months) and in those who underwent OTN reconstruction it was 35.6 months (16-60 months). None of the patients had upper urinary tract deterioration following the reconstructive surgery.


CONCLUSIONS
Urinary bladder rehabilitation either by AC or OTN reconstruction increases the bladder capacity and storage time and also preserves the upper tracts.
Singh
Vishwajeet
V
Department of Urology, CSMMU (formerly KGMU), Lucknow, UP 226003, India. vishwajeeturo@sify.com
Sinha
Rahul Janak
RJ
Sankhwar
S N
SN
Sinha
Seema Mehrotra
SM
D000328:Adult; D002921:Cicatrix / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014401:Tuberculosis, Urogenital / Q000150:complications / Q000601:surgery*; D001745:Urinary Bladder Diseases / Q000150:complications / Q000382:microbiology* / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods; D055815:Young Adult