title: Complications after bladder augmentation in children.
abstract: OBJECTIVE
  Bladder augmentation is an effective surgical procedure for increasing bladder capacity and reducing pressure on the urinary system. It is indicated for patients with anomalies such as spina bifida, myelomeningocele, urethral valve and bladder exstrophy, who progress with low tolerance of medication.
  
  
  METHODS
  This was a retrospective study conducted on pediatric patients submitted to bladder augmentation from 2000 to 2011.
  
  
  RESULTS
  34 patients aged 4 to 17 years were submitted to bladder augmentation, 30 of them with an ileal loop and 4 with a ureter.A continent urinary shunt was performed in 16 patients, the Mitrofanoff conduit was associated in 15, and the Macedo technique was used in one. Mean follow-up was 34.35 months (1 to 122 months). Mean creatinine was 1.5 ng/ml (0.4 to 7.5 ng/ml) preoperatively and 1.78 ng/ml postoperatively. Three patients required a renal transplant during follow-up. There was improvement or resolution of vesicoureteral reflux in 83.5% of the kidneys on the right and in 75% on the left. Bladder capacity increased, on average, from 152.5 ml to 410 ml. The main complications were vesical lithiasis in 3 patients and conduit perforation in one.
  
  
  CONCLUSIONS
  Bladder augmentation showed good results in this series, preserving renal function in most of the patients.
authors.affiliation: Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Brazil.
authors.forename: Carlos Augusto Fernandes
authors.initials: CA
authors.lastname: Molina
authors.affiliation: Universidade Federal do Triângulo Mineiro, Brazil.
authors.forename: Gilson José de
authors.initials: GJ
authors.lastname: Lima
authors.affiliation: Ribeirão Preto Medical School, University of São Paulo, Brazil.
authors.forename: Marcelo Ferreira
authors.initials: MF
authors.lastname: Cassini
authors.affiliation: Ribeirão Preto Medical School, University of São Paulo, Brazil.
authors.forename: Murilo Ferreira de
authors.initials: MF
authors.lastname: Andrade
authors.affiliation: Ribeirão Preto Medical School, University of São Paulo, Brazil.
authors.forename: Inalda
authors.initials: I
authors.lastname: Facincani
authors.affiliation: Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Brazil.
authors.forename: Silvio
authors.initials: S
authors.lastname: Tucci Júnior
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000209:etiology*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery; D001743:Urinary Bladder / Q000601:surgery; D001745:Urinary Bladder Diseases / Q000601:surgery*; D014546:Urinary Catheterization / Q000009:adverse effects; D013520:Urologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods