Laparoscopic augmentation ileocystoplasty: results and outcome.

BACKGROUND

Routine use of laparoscopic augmentation ileocystoplasty has not yet been established.

OBJECTIVES

To assess the outcome of laparoscopic augmentation ileocystoplasty.

DESIGN, SETTING, AND PARTICIPANTS: Twenty-three patients underwent laparoscopic augmentation ileocystoplasty for hypocompliant bladder.

INTERVENTION

Bladder dissection and reconstruction of the ileovesical anastomosis were performed laparoscopically, whereas the ileal pouch was prepared extracorporeally through a small 3- to 4-cm muscle-splitting incision.

MEASUREMENTS

Patient data, operative details, and follow-up were recorded. Urodynamic evaluation was performed preoperatively and after 12 mo, taking the bladder capacity and the maximum detrusor pressure as a measure for the outcome of the procedure.

RESULTS AND LIMITATIONS

All cases were completed laparoscopically, with a mean operative time 202 min; mean hospital stay 5 d, and mean urethral catheter duration 11 d. After 12 mo, the estimated bladder volume increased from a mean 111 ml to 788 ml (p<0.01), whereas the maximum detrusor pressure dropped from a mean 92 cm H(2)O to 15 cm H(2)O (p<0.01). During a mean follow-up of 39 mo, two long-term complications have been reported: bladder stone and spontaneous rupture of the augmented bladder due to neglected clean intermittent self-catheterization.

CONCLUSIONS

Laparoscopic augmentation ileocystoplasty is a safe procedure, technically feasible and with favourable urodynamic outcome.