Evaluation and Management of Failed Bladder Augment

Abstract

Augmentation cystoplasty has been studied and performed by urologists for over 100 years. Although specific indications, techniques, and materials used have undergone major change and revisions during this period, the general concepts have remained unchanged. Bladder augmentation is used to “augment” the bladder’s ability to store. Specific indications include structurally diminished bladder capacity, neurogenically incapacitated bladder, special circumstances of overactive bladder and terminal cases of interstitial cystitis. As augmentation is mostly performed to improve capacity and to eliminate urinary incontinence, most failures relate to the inability to achieve this. Failure to achieve continence, improve bladder capacity or reduce bladder pressures with subsequent upper tract deterioration are results of failed augmentation cystoplasty. Underlying causes of these failures are described in this manuscript.