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Bladder Augmentation—Open Surgery

(Augmentation, Bladder—Open Surgery; Augmentation Cystoplasty—Open Surgery; Cystoplasty, Augmentation—Open Surgery)

Definition

Bladder augmentation makes the bladder bigger.

The Urinary Tract

The Urinary Tract
Copyright © Nucleus Medical Media, Inc.

Reasons for Procedure    TOP

Bladder augmentation makes the bladder large enough to collect urine. When the bladder is too small, it can cause urine to leak out of the body or back up into the kidneys. This can cause an infection in the urinary tract, causing harm to the kidneys. It’s also used when other care methods fail.

Problems, such as long term blockage or birth defects, can cause the bladder to be too small.

Other reasons:

  • Bladder muscle problems causing urine to leak—overactive bladder
  • Nerve problems with the bladder causing urine to leak or be retained—neurogenic bladder

Possible Complications    TOP

Problems from the procedure are rare, but all have some risk. Your doctor will review potential problems such as:

  • Excess bleeding
  • Reaction to anesthesia
  • Infection
  • Blood clots
  • Bladder rupture
  • Incontinence—may be temporary or require more surgery to fix
  • Higher risk of kidney stones

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:

What to Expect    TOP

Prior to Procedure

You may have:

  • Blood and urine tests
  • Imaging tests such as x-rays, ultrasounds, or bladder pressure studies

Talk to your doctor about the medicines you take. You may need to stop them up to 1 week prior to the procedure.

Before surgery, your doctor may advise you:

  • Eat a low-fiber diet.
  • Take antibiotics.
  • Use a prep to clean out your bowels.

Anesthesia

General anesthesia—will block pain and keep you asleep

Description of the Procedure    TOP

An incision will be made in the belly. An incision will also be made on the top part of the bladder. A part of the intestine or stomach will be removed and placed over the opening in the bladder. This new part will work like a patch. The doctor will sew it into place.

A stoma may also be created. This is a small opening through the belly wall to an opening at the top of the bladder. This will make it easier for you to insert the catheter into the bladder.

Immediately After Procedure    TOP

A catheter will be left in place to drain urine from the bladder.

You may be given fluids, pain medicines, and antibiotics. This may be done through an IV. A tube will be placed through your nose to your stomach. This tube will keep your stomach drained. This will stay in place until your stomach and intestines begin working normally again.

How Long Will It Take?    TOP

4-8 hours

How Much Will It Hurt?    TOP

Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medicines.

Average Hospital Stay    TOP

The usual stay is 6-10 days. If you have any problems, you will need to stay longer.

Post-procedure Care    TOP

At the Hospital

The healthcare staff will:

  • Give you fluids and nutrients through an IV—You will not be able to eat until your intestines are working again. This may take a few days. Then, the tube in your nose will be removed. You will start to take fluids by mouth. You will slowly move to soft foods.
  • Have you take deep breaths to keep your lungs clear.
  • Have you walk around.
  • Teach you how to use the catheter. It’s placed through the urethra or through the stoma. If you’re better, the catheter placed during surgery will be taken out.
  • Teach you how to wash out the bladder using salt water and a catheter.

During your stay, the healthcare staff will take steps to lower your chance of infection such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

There are also steps you can take to lower your chance of infection such as:

  • Washing your hands often and reminding your healthcare staff to do the same
  • Reminding your healthcare staff to wear gloves or masks
  • Not letting others touch your incision

At Home

To help you get healthier faster:

  • Follow the directions in caring for your catheter. You may see blood in the urine for a few weeks.
  • If you are catheterizing yourself, carefully follow the plans for draining your bladder.
  • Wash out the bladder as advised. This is especially important if you have a piece of the intestine attached to your bladder. The intestine patch will continue to make mucus. This can clog the catheter tube.

Call Your Doctor    TOP

Call your doctor if any of these occur:

  • Fever or chills
  • Signs of infection from the incision or stoma:
    • Redness
    • Swelling
    • Pain
    • Bleeding
    • Pus
  • Nausea or vomiting
  • Belly pain
  • Urinary problems such as:
    • Little output
    • Extreme cloudiness
    • Presence of pus
    • Bad odor
  • Trouble placing the catheter or washing it out

If you think you have an emergency, call for emergency medical services right away.

RESOURCES:

National Institute of Diabetes and Digestive and Kidney Diseases
https//www.niddk.nih.gov
Urology Care Foundation
http://www.urologyhealth.org

CANADIAN RESOURCES:

The Kidney Foundation of Canada
https://www.kidney.ca

References:

Bladder augmentation. Boston Children’s Hospital website. Available at:
...(Click grey area to select URL)
Accessed June 13, 2018.
Bladder augmentation (enlargement). Urology Care Foundation website. Available at:
...(Click grey area to select URL)
Accessed June 13, 2018.
Bladder augmentation surgery FAQ. UCSF Benioff Children’s Hospital website. Available at: https://www.ucsfbenioffchildrens.org/education/bladder_augmentation_surgery/index.html. Accessed June 13, 2018.
6/2/2011 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.
Last reviewed June 2018 by EBSCO Medical Review Board Adrienne Carmack, MD
Last Updated: 6/13/2018

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