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Bladder Augmentation—Laparoscopic Surgery

(Augmentation Cystoplasty—Laparoscopic Surgery)

Definition

Bladder augmentation is surgery to make the bladder bigger.

The Urinary Tract
The Urinary Tract

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Reasons for Procedure

Bladder augmentation makes the bladder large enough to collect urine. It may be used to treat:

  • A bladder that is too small—due to a blockage, birth defect or other problem
  • Overactive bladder—muscle problems that cause urine to leak
  • Neurogenic bladder—nerve problems in the bladder that cause urine to leak or not come out

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Excess bleeding
  • Problems from anesthesia
  • Infection
  • Blood clots
  • Bladder rupture
  • Not being able to hold urine
  • Higher risk of kidney stones

Things that may raise the risk of problems are:

What to Expect

Prior to Procedure

The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Whether you need a ride to and from surgery
  • Tests that will need to be done before surgery
  • Cleaning the colon before surgery

Anesthesia

General anesthesia will be used. You will be asleep.

Description of the Procedure

Several small incisions will be made in the belly. A small tube with a camera on the end (laparoscope) will be inserted. This will help the doctor see inside the area.

An incision will be made on the top of the bladder. Other tools will be inserted. A piece of the intestine or stomach will be removed. The intestine or stomach will be repaired. Next, a piece of the intestine or stomach is attached to the bladder. This makes the bladder larger.

Sometimes, a small opening called a stoma is made. It goes from the belly wall to an opening that at the top of the bladder. This helps drain urine from the bladder. The incisions will be closed with stitches. A bandage will be placed over the site.

The doctor may need to change to an open procedure. If this happens, a larger incision will be made. The healing time will also be longer.

How Long Will It Take?

About 4 hours

Will It Hurt?

Pain and swelling are common in the first few weeks. Medicine and home care help

Average Hospital Stay

The usual hospital stay is 3 to 5 days. If you have any problems, you will need to stay longer.

Post-procedure Care

At the Hospital

Right after the procedure, the staff may:

  • Give pain medicine
  • Give you fluids and nutrients through an IV until your intestines are working again
  • Teach you how to use the catheter to drain urine from the bladder

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

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

You can also lower your chance of infection by:

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

At Home

It will take a month or more to recover. You may see some blood in the urine during this time.

Strenuous physical activity will also be limited.

Call Your Doctor

Call your doctor if you are not getting better or you have:

  • Signs of infection such as fever or chills
  • Redness, swelling, excess bleeding, or discharge from the incision
  • Nausea or vomiting
  • Problems urinating or urine that is cloudy or smells bad

If you think you have an emergency, call for medical help 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:

Health Canada
https://www.canada.ca

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

REFERENCES:

Bladder augmentation. Boston Children’s Hospital website. Available at: http://www.childrenshospital.org/conditions-and-treatments/treatments/bladder-augmentation. Accessed January 4, 2021.

Bladder augmentation (enlargement). Urology Care Foundation website. Available at: http://www.urologyhealth.org/urologic-conditions/bladder-augmentation-(enlargement). Accessed January 4, 2021.

Bladder augmentation surgery FAQ. UCSF Benioff Children’s Hospital website. Available at: https://www.ucsfbenioffchildrens.org/education/bladder_augmentation_surgery/index.html. Accessed January 4, 2021.

Neurogenic bladder. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/neurogenic-bladder. Accessed January 4, 2021.

Nimeh T, Elliott S. Minimally invasive techniques for bladder reconstruction. Curr Urol Rep. 2018 Apr 13;19(6):39.

Last reviewed September 2020 by EBSCO Medical Review Board Adrienne Carmack, MD  Last Updated: 1/4/2021