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
ARTICLE HIGHLIGHTS
Research background

Intestinal bladder augmentation is widely used for neurogenic bladder with good results and is standard cystoplasty (SC). However, due to the mucous secretion and reabsorption function of the intestinal mucosa, many related complications occur. To preclude the contact of urine with gastrointestinal mucosa, alternative methods have been investigated. Seromuscular bladder augmentation (SMBA) could effectively expand the bladder capacity and avoid complications related to integrating the intestinal mucosa into the bladder.

Research motivation

SMBA was not widely accepted and was only reported in a few institutions. Further study is needed to evaluate the safety and effectiveness of SMBA in the treatment of neurogenic bladder.

Research objectives

The aim of our study was to assess the outcomes of patients undergoing SC and SMBA to evaluate the safety and effectiveness of SMBA in the treatment of patients with neurogenic bladder.

Research methods

This study retrospectively analyzed the clinical data of children with SMBA and compared the data with those of children with SC completed during the same period.

Research results

No significant difference was found in the preoperative urinary dynamic parameters between the two groups, but the comparison after operation was statistically significant. The main complications after SMBA were residual ureteral reflux and failed bladder augmentation. All 6 patients with failed augmentation in the SMBA group used ileum seromuscular patches for augmentation, and SC was chosen for reaugmentation. During the reoperation, patch contracture and fibrosis were observed.

Research conclusions

The improvement of the urodynamic parameters in the SMBA group was significantly poorer than that in the SC group. The probability of patch contracture and reaugmentation was higher, likely related to an impaired blood supply and urine irritation, and the sigmoid colon patch should be the priority.

Research perspectives

This study was a retrospective study, and each group had different concomitant operations, which might affect the evaluation of the outcomes. Histopathological research was not performed on the shrunken patch, and collagen deposition was not observed. In the future, prospective and controlled studies are needed to support our conclusions.