Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 16, 2022; 10(23): 8115-8123
Published online Aug 16, 2022. doi: 10.12998/wjcc.v10.i23.8115
Outcomes of seromuscular bladder augmentation compared with standard bladder augmentation in the treatment of children with neurogenic bladder
Xiao-Gang Sun, Yan-Xia Li, Long-Fei Ji, Jia-Long Xu, Wei-Xiu Chen, Ruo-Yi Wang
Xiao-Gang Sun, Jia-Long Xu, Wei-Xiu Chen, Ruo-Yi Wang, Department of Pediatric Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250033, Shandong Province, China
Yan-Xia Li, Department of Neurology, Shandong Second Provincial General Hospital, Shandong Provincial ENT Hospital, Jinan 250011, Shandong Province, China
Long-Fei Ji, Department of Pediatric Surgery, Dongying District People’s Hospital, Dongying 257000, Shandong Province, China
Author contributions: Wang RY and Li YX conceived and designed the analysis; Xu JL and Ji LF collected the data; Chen WX supervised the analysis; Sun XG wrote the paper.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of The Second Hospital, Cheeloo College of Medicine, Shandong University.
Informed consent statement: Informed consent was obtained from the parents or guardian of the patients.
Conflict-of-interest statement: The authors reported no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ruo-Yi Wang, MD, Professor, Department of Pediatric Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, No. 247 Beiyuan, Jinan 250033, Shandong Province, China. sxg17660082198@163.com
Received: December 11, 2021
Peer-review started: December 11, 2021
First decision: January 10, 2022
Revised: January 21, 2022
Accepted: July 16, 2022
Article in press: July 16, 2022
Published online: August 16, 2022
Processing time: 232 Days and 21.5 Hours
Abstract
BACKGROUND

Intestinal seromuscular bladder augmentation (SMBA) surgery has produced no mucosal-related complications, but its outcomes need to be studied.

AIM

To evaluate the safety and effectiveness of SMBA in the treatment of children with neurogenic bladder.

METHODS

A retrospective analysis of the clinical data of children with SMBA was performed from March 2008 to February 2018, and the data were compared with those of children receiving standard cystoplasty (SC).

RESULTS

In a cohort of 67 children who underwent bladder augmentation, the 46 children in the SC group had an average age of 10.6 years and a follow-up time of 36 mo, and the 21 children in the SMBA group had an average age of 7.6 years and a follow-up time of 29.7 mo. The preoperative and postoperative bladder volumes in the SMBA group were 151.7 mL and 200.4 mL, respectively, and those in the SC group were 173.9 mL and 387.0 mL, respectively. No significant difference in preoperative urinary dynamic parameters was found between the two groups, but the difference after operation was statistically significant. The main complications after SMBA were residual ureteral reflux and failed bladder augmentation, with incidences of 33.3% and 28.6%, respectively. In all 6 patients with failed augmentation in the SMBA group, ileum seromuscular patches were used for augmentation, and SC was chosen for reaugmentation. During reoperation, patch contracture and fibrosis were observed.

CONCLUSION

The improvement of urinary dynamic parameters in the SMBA group was significantly lower than that in the SC group. Children with SMBA had a higher probability of patch contracture and reaugmentation, which might be related to impaired blood supply and urine stimulation, and the sigmoid colon patch should be the priority.

Keywords: Neurogenic bladder; Seromuscular bladder augmentation; Bladder; Surgery; Urinary dynamic parameter

Core Tip: We performed a retrospective review of the mid-term outcomes of patients undergoing two bladder augmentation procedures for neurogenic bladder in a single institution. We studied a total of 67 patients who underwent standard cystoplasty (SC) or seromuscular bladder augmentation (SMBA). In the SMBA procedure, a double-layer intestinal seromuscular patch was used. We found that the improvement of urinary dynamic parameters in the SMBA group was significantly lower than that in the SC group. Children with SMBA had a higher probability of patch contracture and reaugmentation, which might be related to impaired blood supply and urine stimulation.