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Laparoscopic augmentation ileocystoplasty: results and outcome.

Research paper by Ahmed A el-Feel, Mahmoud A MA Abdel-Hakim, Hazem H Abouel-Fettouh, Amr M AM Abdel-Hakim

Indexed on: 19 Apr '08Published on: 19 Apr '08Published in: European Urology



Abstract

Routine use of laparoscopic augmentation ileocystoplasty has not yet been established.To assess the outcome of laparoscopic augmentation ileocystoplasty.Twenty-three patients underwent laparoscopic augmentation ileocystoplasty for hypocompliant bladder.Bladder dissection and reconstruction of the ileovesical anastomosis were performed laparoscopically, whereas the ileal pouch was prepared extracorporeally through a small 3- to 4-cm muscle-splitting incision.Patient data, operative details, and follow-up were recorded. Urodynamic evaluation was performed preoperatively and after 12 mo, taking the bladder capacity and the maximum detrusor pressure as a measure for the outcome of the procedure.All cases were completed laparoscopically, with a mean operative time 202 min; mean hospital stay 5 d, and mean urethral catheter duration 11 d. After 12 mo, the estimated bladder volume increased from a mean 111 ml to 788 ml (p<0.01), whereas the maximum detrusor pressure dropped from a mean 92 cm H(2)O to 15 cm H(2)O (p<0.01). During a mean follow-up of 39 mo, two long-term complications have been reported: bladder stone and spontaneous rupture of the augmented bladder due to neglected clean intermittent self-catheterization.Laparoscopic augmentation ileocystoplasty is a safe procedure, technically feasible and with favourable urodynamic outcome.