Early experience of gastrocystoplasty for tuberculous contracted bladder

Park, Jun Seok; Park, Nam Cheol; Yoon, Jong Byung

Abstract

Recently the stomach has been used with increasing frequency as an alternative to other bowel segments for auementing the bladder. The proposed advantages include decreased mucus production, reduced urinary infection due to an acid milieu, decreased metabolic abnormalities secondary to chloride excretion, and potential availability in patients with limited bowel length. The wedge gastrocystoplasty was performed in three patients of tuberculous contracted bladder, 2 females and 1 male, aged 22,51 and 57 years. On the excretory urogram, postoperative hydronephrosis was slightly improved as compared with preoperative one. Voiding cystogram showed no vesicoureteral reflux with reasonable capacity in all patients. Urgency, frequency, incontinence and voiding difficulty disappeared within 1 month postoperatively. When postoperative urodynamic studies were compared with the preoperative evaluation, it was noted that overall capacity was increased to an average of 235% (range 91 to 460%) at 2 months after surgery. Compliance has also improved dramatically after surgery. Three patients have been followed for at least 5 months, with the longest followup being 9 months. All patients reveal normal voiding patterns without gastric or urinary complications. We believe that a gastric segment is a suitable alternative to an intestinal segment especially in azotemic patient for reconstructine the urinary bladder. But the longterm effects of gastric augmentation remains to be determined.