What is the Need for Additional Bladder Surgery After Bladder Augmentation in Childhood?

P. D. Metcalfe, M. P. Cain, Martin Kaefer, D. A. Gilley, K. K. Meldrum, R. Misseri, S. J. King, A. J. Casale, R. C. Rink

Research output: Contribution to journalArticle

95 Citations (Scopus)

Abstract

Purpose: Bladder augmentation has revolutionized the care of children with a neuropathic bladder but it remains a major surgical procedure. However, the need for subsequent bladder surgery has not been well defined in a large series with long-term followup. Materials and Methods: We retrospectively reviewed the records of the first 500 bladder augmentations performed from 1978 to 2003 at our institution. Charts were reviewed for complications requiring additional surgery, including malignancy, bladder perforation, repeat augmentation, bowel obstruction and bladder calculi. Mean and median followup was 13.3 years. Results: Complications occurred in 169 patients (34%) resulting in a total of 254 surgeries. The cumulative risk of further surgery at the bladder level was 0.04 operations per patient per year of augmentation. Three patients (0.6%) had transitional cell carcinoma, of whom all presented with metastatic disease and died. Bladder perforation occurred in 43 patients (8.6%) with a total of 53 events. Of the patients 16 (3.2%) required laparotomy for bowel obstruction and 47 (9.4%) required repeat augmentation. Bladder stones were treated in 75 patients (15%), who required a total of 125 surgeries. Conclusions: Bladder augmentation provides immeasurable improvements in quality of life but it requires lifelong dedication from the patient, family and health care providers. While the requirements for additional surgery are not trivial, 66% of our patients have not required any further surgery in the augmented bladder.

Original languageEnglish
Pages (from-to)1801-1805
Number of pages5
JournalJournal of Urology
Volume176
Issue number4 SUPPL.
DOIs
StatePublished - Oct 2006

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Urinary Bladder
Urinary Bladder Calculi
Neurogenic Urinary Bladder
Family Health
Transitional Cell Carcinoma
Anniversaries and Special Events
Child Care
Health Personnel
Laparotomy
Patient Care
Quality of Life
Neoplasms

Keywords

  • bladder
  • calculi
  • complications
  • neoplasms
  • urinary diversion

ASJC Scopus subject areas

  • Urology

Cite this

Metcalfe, P. D., Cain, M. P., Kaefer, M., Gilley, D. A., Meldrum, K. K., Misseri, R., ... Rink, R. C. (2006). What is the Need for Additional Bladder Surgery After Bladder Augmentation in Childhood? Journal of Urology, 176(4 SUPPL.), 1801-1805. https://doi.org/10.1016/j.juro.2006.03.126

What is the Need for Additional Bladder Surgery After Bladder Augmentation in Childhood? / Metcalfe, P. D.; Cain, M. P.; Kaefer, Martin; Gilley, D. A.; Meldrum, K. K.; Misseri, R.; King, S. J.; Casale, A. J.; Rink, R. C.

In: Journal of Urology, Vol. 176, No. 4 SUPPL., 10.2006, p. 1801-1805.

Research output: Contribution to journalArticle

Metcalfe, PD, Cain, MP, Kaefer, M, Gilley, DA, Meldrum, KK, Misseri, R, King, SJ, Casale, AJ & Rink, RC 2006, 'What is the Need for Additional Bladder Surgery After Bladder Augmentation in Childhood?', Journal of Urology, vol. 176, no. 4 SUPPL., pp. 1801-1805. https://doi.org/10.1016/j.juro.2006.03.126
Metcalfe, P. D. ; Cain, M. P. ; Kaefer, Martin ; Gilley, D. A. ; Meldrum, K. K. ; Misseri, R. ; King, S. J. ; Casale, A. J. ; Rink, R. C. / What is the Need for Additional Bladder Surgery After Bladder Augmentation in Childhood?. In: Journal of Urology. 2006 ; Vol. 176, No. 4 SUPPL. pp. 1801-1805.
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