ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

Abstract: FR-PO645

Long-Term Complications and Outcomes of Augmentation Cystoplasty in Children with Neurogenic Bladder

Session Information

  • Pediatric Nephrology - II
    November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1900 Pediatric Nephrology

Authors

  • Tsai, Hsin-Lin, Taipei Veterans General Hospital, Taipei, Taiwan
  • Chang, Jei-Wen, Taipei Veterans General Hospital, Taipei, Taiwan
  • Lin, Tzu-Ching, Taipei Veterans General Hospital, Taipei, Taiwan
Background

Controversy still exists regarding complications especially malignancy and long-term outcomes of augmentation cystoplasty (AC) in children with neurogenic bladder.

Methods

Pediatric patients <18 years underwent AC between 2000 and 2020 were enrolled. Early postoperative complications, long-term outcomes and histopathologic changes in mucosal biopsies of native bladder and the augmented intestine after AC were reviewed.

Results

Twenty-two patiients with mean age of 7.6±4.4 years were included. The ileum was used in 19 patients and the sigmoid colon in 3 patients. The length of hospital stay was 14.8±6.8 days. Post-operatively, urinary continence rate improved from 22.7% to 86.4% (p<0.001). Vesicoureteral reflux resolved in 16 (64.0 %) of the refluxing ureter units and was downgraded in 8 (32.0%). Hydronephrosis resolved in 17 of 19 patients. Grades of reflux and hydronephrosis significantly improved following AC (p<0.001). The estimated glomerular filtration rate also significantly increased (p=0.012). Formation of urinary tract stones was the most frequent late complication (in 8 patients, 36.4%). After a mean follow-up of 13.4±5.9 years, there were no cases of mortality, new-onset symptomatic metabolic acidosis, or effects on serum electrolytes. No cases of malignancy or metaplastic changes were identified in the native bladder or augmented bowel epithelium.

Conclusion

AC is a safe and effective procedure with low surgical and metabolic complication rates. AC provides a satisfactory continence rate and long-term protection of renal function, increases functional capacity, and regresses reflux and hydronephrosis. Individualized surveillance is recommended for the early identification of urolithiasis and metabolic disturbance.

Table 1 &2

Table 3 Renal and functional outcomes after augmentation cystoplasty

Funding

  • Government Support – Non-U.S.