Laparoscopic bladder augmentation and urinary diversion

Karl J. Kreder

doi:10.3109/9780203341025-48

Augmentation cystoplasty remains the most widely accepted reconstructive technique for creating a compliant, large capacity bladder that protects the upper urinary tract and provides urinary continence in people with bladder dysfunction secondary to noncompliance or reduced functional capacity.1-4 This form of bladder reconstruction may even be combined with a continent catheterizable stoma for use as an accessible port for bladder emptying. In 1888, Tizzoni and Poggi demonstrated the feasibility of performing ileocystoplasty in a canine model. Ten years later, Mickulicz performed the first clinical ileocystoplasty.5 Since that time, the standard enterocystoplasty has classically evolved as a procedure performed through an open laparotomy incision utilizing various segments of well-vascularized segments of the gastrointestinal system that are reconfigured before anastomosis with the urinary bladder.6 One hundred years have passed since the original open approach for this procedure has become an established reconstructive technique performed laparoscopically. No matter what approach is chosen, the use of any bowel segment for augmentation is associated with advantages and disadvantages, but the versatility of choosing a particular bowel segment, for both open and laparoscopic approaches, provides a variety of clinical options based on an individualized set of objectives for the person requiring this form of bladder reconstruction.

Laparoscopic bladder augmentation and urinary diversion

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