Ureterocystoplasty in a Boy with Myelomeningocele

Abstract

Introduction In the rare case of a decompensated neurogenic bladder combined with a unilateral hydronephrosis and hydroureter, ureterocystoplasty is a feasible and elegant technique for bladder augmentation. In contrast to augmentation using bowel segments, the use of urothelial-lined tissue avoids the common problems caused by mucus development and electrolyte disturbance. Prerequisite is a unilateral non-functional kidney and a severe dilation of the ureter. Patients The patient presented in this case report is an 11-year old boy with myelomeningocele. Due to a decompensated neurogenic low-compliance bladder with high-degree reflux, the left kidney was hydronephrotic and afunctional, urodynamic revealed a maximum bladder capacity of 70ccl, therefore unilateral nephrectomy and ureterocystoplasty were performed. Results Three years after surgery the patient is continent day and night. Urodynamic evaluation shows a normal compliance, bladder capacity is 440cc. The boy empties his bladder 4-6 times a day by means of clean intermittent catheterization. Conclusions In selected cases ureterocystoplasty is a safe and feasible technique for bladder augmentation.