Long-Term Outcomes of Augmentation Enterocystoplasty with a Catheterizable Channel in the Adult Neurogenic Population

Abstract

Augmentation enterocystoplasty with a continent catheterizable stoma is a common approach to refractory neuropathic bladder, incontinence and end-stage bladder disease that aims to provide a large capacity, low-pressure reservoir and continent stoma. The goal is to not only to prevent renal deterioration, but also provide the patient with an improved quality of life. Several recent studies, reviewed in this chapter, have assessed the long-term outcomes of these procedures, demonstrating durable improvement in bladder capacity, bladder compliance, continence and quality of life. The long-term complications of the surgery include stomal complications such as stenosis and prolapse, channel related complications leading to difficult catheterization, bladder stones, recurrent urinary tract infections, bladder rupture, metabolic derangement and in very rare cases, malignant transformation. Successful surgery and good outcomes depend on proper patient selection, surgeon and center experience with the procedure, and close follow-up.