Abstract
We describe the case of a 9 year old boy with neurogenic bladder dysfunction who co-incidentally had a unilateral duplex kidney with Grade 5 vesico-ureteric reflux into a poorly functioning lower moiety allowing heminephrectomy and ureterocystoplasty with preservation of ipsilateral renal function.
Highlights
The use of ureter for bladder augmentation was first described by Mitchell in 1992 [1]
Ureterocystoplasty avoids the need to use an intestinal segment with its recognised complications of mucus formation, calculi, metabolic acidosis, abnormalities of calcium metabolism and potentially malignancy
Urodynamic study revealed a poorly compliant bladder with a reduced capacity (60% of expected for age) and a detrusor Leak point pressure of 41 cm H20. He was commenced on intermittent self-catheterisation (CIC), anticholinergics and was scheduled for neurosurgical review which revealed re-tethering of his spinal cord on MRI and is under evaluation for re-do surgery
Summary
The use of ureter for bladder augmentation was first described by Mitchell in 1992 [1]. Ureter is the tissue of choice for augmentation because of its urothelial lining. A ureter of suitable calibre is rarely available to the urological surgeon. Ureterocystoplasty avoids the need to use an intestinal segment with its recognised complications of mucus formation, calculi, metabolic acidosis, abnormalities of calcium metabolism and potentially malignancy. While surgical techniques are described to produce an urothelial-lined reservoir, such as auto-augmentation or. Peer review under responsibility of Pan African Urological Surgeons’ Association
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