The Clinical Experience of the Bladder Augmentation with Goodwin's Ileal Cup-patched Bladder

Lee, Joong Shik; Mah, Sang Yol

Abstract

PURPOSE: Augmentation enterocystoplasty is a valuable technique, as a surgical repertoire, for urologists treating a myriad of conditions that cause either a small anatomic or functional bladder capacity. A variety of surgical techniques for augmentation cystoplasty have been developed. The clinical availability of augmentation cystoplasty was evaluated using a Goodwin's ileal cup-patched bladder in patients with a small capacity, high pressure, poorly compliant and unstable bladder.
MATERIALS AND METHODS
At our institute, 21 patients, with a neurogenic bladder, have undergone augmentation cystoplasty using a Goodwin's ileal cup-patched bladder, since July 1999. The mean age at operation and follow-up period were 32 years and 11 months, respectively. 9 patients had various degrees of vesicoureteral reflux. The preoperative assessments included urinalysis, urine culture, renal function tests, voiding cystourethrography and urodynamic evaluation.
RESULTS
The mean bladder capacity increased from 170cc preoperatively to 438cc postoperatively. The mean maximal end-filling intravesical pressure decreased from 55cmH2O to 22cmH2O, with a significant increase in bladder compliance. There were no significant complications that required surgical revision.
CONCLUSIONS
Augmentation cystoplasty using a Goodwin's ileal cup-patched bladder offers a high success rate, with low complications, in selected patients with neurogenic bladder dysfunction.