918 THE USE OF AN INTRAVESICAL SILICON INFLATABLE BALOON DEVICE IMPROVES RESULTS OF BLADDER AUTOAUGMENTATION TECHNIQUE: LONG TERM FOLLOW UP

Abstract

You have accessJournal of UrologyPediatrics: Reconstructive Surgery1 Apr 2010918 THE USE OF AN INTRAVESICAL SILICON INFLATABLE BALOON DEVICE IMPROVES RESULTS OF BLADDER AUTOAUGMENTATION TECHNIQUE: LONG TERM FOLLOW UP Flavio Trigo-Rocha, Marcos Machado, Cristiano Gomes, Frederico Mascarenhas, Homero Bruschini, Jose Alaor Figueiredo, and Miguel Srougi Flavio Trigo-RochaFlavio Trigo-Rocha More articles by this author , Marcos MachadoMarcos Machado More articles by this author , Cristiano GomesCristiano Gomes More articles by this author , Frederico MascarenhasFrederico Mascarenhas More articles by this author , Homero BruschiniHomero Bruschini More articles by this author , Jose Alaor FigueiredoJose Alaor Figueiredo More articles by this author , and Miguel SrougiMiguel Srougi More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1708AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The majority of the authors have reported disappointing results with auto augmentation surgeries for the treatment of low capacity, low compliance neurogenic. The failure may be due to the diverticulum's ischemia of the as well as the shrink of mucosa in the early postoperative period. We investigate if the use of a silicone balloon (Silimed®) inside the bladder after auto augmentation could prevent shrink and ischemia of the mucosa thus improving surgical results. METHODS We have compared our results of standard bladder auto augmentation carried in a group of 12 neurogenic bladder children (group I) with another group of 10 children submitted to the same surgery using a bladder conformer (group II). The bladder conformer was a silicon balloon filled with 50 to 100 ml of saline left inside the bladder for two weeks. The balloon had a conduct and a port to allow its removal. The main indication for surgery in all patients was poor bladder compliance resulting urinary leakage between intermittent catheterism. Four patients in group one and two in group two had upper urinary tract dilation (UUTD). Pre and postoperative evaluation included a voiding diary, ultrasound and urodynamics. RESULTS Mean follow-up is 61.4 months (range 42 to 132 months). In the group I just one patient becomes dry, 4 presented little improvement in continence, four remained unchanged and three got worse. In group II 6 patients become continent without medication (60%), 2 (20%) become continent with oxybutinin and 2 remained unchanged. Bladder capacity in group two changed from 140 ml (mean) to 240 ml (mean) and the compliance increased from 15.6 ± 16.8 ml/cmH2O to 34.3 ± 22.8 ml/cmH2O; p = 0.02. From the four patients with UUTD in group I just one showed improvement. In group II the two patients showed regression of the dilation. No significant complications were observed in any patient. CONCLUSIONS The use of a bladder silicone model significantly improved our results with bladder auto-augmentation in a long term follow up. A larger number of patients may be necessary to confirm this procedure as a safe and effective alternative to bladder in order to reduce surgical morbidity. Sao Paulo, Brazil© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e358 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Flavio Trigo-Rocha More articles by this author Marcos Machado More articles by this author Cristiano Gomes More articles by this author Frederico Mascarenhas More articles by this author Homero Bruschini More articles by this author Jose Alaor Figueiredo More articles by this author Miguel Srougi More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...