Ureterocystoplasty: the 'bladder' augmentation of choice.

OBJECTIVE

To reduce the complications of enterocystoplasty by augmenting the bladder with a megaureter.

PATIENTS AND METHODS

Ureterocystoplasty was performed in eight children aged 20 months-15 years. Three had impaired renal function and three were in established chronic polyuric renal failure.

RESULTS

The seven older children were dry by day with clean intermittent catheterization and the youngest, at the age of 3 1/2 years, had a dry interval of 2 h after catheterization. The three children with polyuric renal failure required nocturnal catheterization or were wet at night. The post-operative urodynamics showed a significant improvement in all cases with abolition of detrusor instability in seven patients and a reduction in end filling pressure. Bladder volume increased from a mean of 100 ml (range 45-215) to 311 ml (range 150-450) (P = 0.01). There was no deterioration in renal function.

CONCLUSION

The early results of ureterocystoplasty compare favourably with those of enterocystoplasty without the risks of long-term metabolic and neoplastic complications.