Purpose: We present long-term results on the use of demucosalized intestine for reconstructive surgery of the bladder.
Materials And Methods: A total of 129 bladder augmentations with demucosalized intestine were performed in 123 patients (55% males and 45% females) 3 months to 53 years old during the last 10 years. Of the patients 82 presented with neurogenic bladder, 40 with bladder exstrophy, 3 each with tuberculosis and posterior urethral valves, and 1 with female hypospadias. Sigmoid was used in 104 cases and ileum in 25. In 105 cases a silicone balloon was left inside the augmented bladder for 2 weeks. In the remaining cases bladder mucosa was preserved and no mold was used. A silicone inflatable bladder neck cuff was implanted at the same time as augmentation in 32 patients.
Results: Followup ranged from 3 to 135 months (median 51.0). There was a 329% increase in bladder capacity and compliance increased 7-fold. There were 13 (10.1%) cases considered failures, which were treated with reaugmentation using demucosalized ileum (6), different forms of augmentation (5) and no reaugmentation (2). There was no mucus formation, bladder perforation or neoplasia.
Conclusions: Based on our study we conclude that demucosalized intestine is a safe alternative for bladder augmentation and can be used for the same indications as total bowel segments.
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