Augmentation Cystoplasty

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Bladder augmentation is a surgical alteration of the urinary bladder. It involves removing strips of tissue from the intestinal tract and adding this to the tissue of the bladder. … Read More

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Augmentation Cystoplasty

Cystoplasty is a plastic surgery done on the urinary bladder. Augmentation is the action or process of making or becoming greater in size or amount. Therefore, Augmentation Cystoplasty is a surgical procedure done to increase the size of the urinary bladder in pediatric or adult patients.


This procedure is done in people who:
  • Lack of adequate bladder capacity  
  • Detrusor in compliance. (The detrusor muscle is a smooth muscle found in the wall of the bladder. It relaxes to allow the bladder to store urine and contract to release urine.)
  • Incontinence is the inability to hold urine.
  • When there is a lack of spasticity in the bladder.
  • Shrinking of the bladder caused by radiations or injury on the spinal cord.
For many of these patients, augmentation cystoplasty can provide a safe, functional reservoir that allows for urinary continence and prevent deterioration of the upper urinary tract. It is also done to:
  • Increase the amount of urine that the bladder can hold
  • Lower the rate of pressure at which the bladder stores urine and reduce the risk of kidney damage.


Any patient with a marked reduction in bladder capacity or compliance may be a candidate for augmentation cystoplasty. Some of the conditions that can act as indications for augmentation cystoplasty include:
  • Urine Incontinence; the patient is unable to hold urine and so sometimes wets himself or herself.
  • Stiffness of the bladder, which can be due to several reasons including cystitis (inflammation of the bladder).
  • Shrinking of the bladder due to treatments (like radiation therapy) or diseases (like spinal cord injury or a congenital spinal defect).
  • Failure of the bladder to work properly. This can sometimes lead to an increase in pressure in the bladder and lead to reflux of urine back towards the kidneys. This can lead to kidney infections and damage to the kidneys. 
Generally, augmentation cystoplasty is considered when bothersome symptoms impair a patient’s lifestyle despite medical treatment. Unfortunately, not every patient with these indications can have the procedure. Patients with inflammatory bowel disease (especially Crohn’s disease), a short or shrunken bowel, bladder tumors, or severe radiation cystitis should not undergo augmentation cystoplasty. There is a high probability that life-long intermittent catheterization will be required, so patients who are unwilling or unable to go through this should not undergo augmentation cystoplasty.


Before the Surgery You will have a series of tests and examinations including:
  • A physical examination.
  • Examination of the bladder could be radiological imaging or cystoscopy.
  • A test of urinary continence and how full the bladder is before it starts to leak or transmit pressure to the kidneys.
  • Urine test to ascertain the presence of infections
  • Blood test.
You will also perform a bowel prep to clean out his or her bowels before the surgery.  During Surgery, You will be taken to the operating room and General anesthesia is given. Usually, this surgery takes 3 to 4 hours. This is abdominal surgery, so the surgeon cuts the patient’s abdomen to get to the bladder. This incision will reveal the bladder underneath and so the surgeon cuts open the bladder at the top. The surgeon then removes a section of the small or large intestine, cuts the section open so that it becomes flat instead of a tube. The surgeon attaches the tabularized section of the bowel to the bladder. They are sewn together to make the bladder larger.   After Surgery, You will be moved into the ICU for a day or two for close observation and will be placed on painkillers to reduce pain. After, you will be moved to your room and may be required to stay in the hospital for five to seven days.  You will not be allowed to eat or drink for a couple of days after the surgery but will be fed through an intravenous line A nasogastric tube will be given, which is a tube inserted through the nostril into the stomach that helps remove fluid produced by the stomach. This gives time for the stomach to heal after some days. You should expect that your urine will have mucous in it because the bowel is now in contact with the bladder system. You will have to irrigate this mucous regularly (usually every morning) for the rest of your life. If this is not done, you can develop stones and this will need additional surgery to remove. Some weeks after the surgery, you will have a radiological test to ensure the new bladder is not leaking. Antibiotics and some medications will be given intravenously. This is to help prevent blood clotting in the leg veins. Chest physiotherapy will also be carried out to prevent chest infections. Oxygen also is administered especially during the first 24 hours after surgery to help with breathing and healing. You should be ready to resume normal activities six weeks after the surgery. Because the bladder is no longer made of only ladder muscle, you will no longer be able to empty yours through urination alone. You will most likely to self-catheterize for the rest of your life. You will be taught how to do this about three weeks after surgery. 


Recovery time varies with individuals and also how severe the condition was before the surgery. Although, it could take two to four weeks of healing before activities of your normal life may begin. It may take 6weeks before sexual activity may begin.


The success rate of augmentation cystoplasty is high as 75% of cases have been recorded to have recovered, 20% improved, with only about 5% having major complications, and 16%  of cases needing a revision surgery over the next 3-5 years.

LifeStyle That Aids Recovery

There certain lifestyles that could help the recovery and healing process. They include:
  • Frequent drinking of water to help to flush mucous from the bladder
  • Avoiding strenuous activity including strenuous sports and exercises especially the first 6 weeks after surgery
  • Keeping regular visit to the hospital
  • Avoid smoking and reduce the intake of alcohol


Although death is rare it is also possible. There are also other complications which include:
  • Heart attack and heart failure
  • Stroke
  • Pulmonary embolism due to blood clotting at the deep vein of the leg.
  • Damage to the ureters, bowel, blood vessels, and blood-nerve.
  • Bleeding might require a blood transfusion.
  • Infections and injury in the abdomen.
  • Bowel obstruction.
  • The leak of urine from the bladder requiring a catheter for a very long time.
  • Failure for the bladder to be adequately expanded.
  • Development of stress and anxiety.
  • Vitamin B12 deficiency due to the removal of the ileum.
  • Infections in the kidney.
  • Bladder rapture.
  • Sometimes, stones may be formed and cancer may also result. Though these cases are rare.


• Detrusor instability.
• Chronic cystitis, including tuberculosis and schistosomiasis.
• Interstitial cystitis.
• Radiation cystitis.
• Classic or cloacal exstrophy.
• Defunctionalized bladder in a patient who is on dialysis.


  • What does cystoplasty mean?

Cystoplasty is a term used to describe the act of opening the bladder or making an incision of the bladder as a treatment for such diseases and urinary infections and disorders.

  • How long do you have to wear a catheter after surgery?

The catheter most times have to stay until the blood in your urine has cleared out then.  these usually take 1 to 3 days.

  • How does it feel urinating with a catheter?

At first, you may feel slightly uncomfortable as you will have to adjust to the burning feeling around your urethra. Sometimes the pain could come suddenly and with urgency to pee but with time you will adjust to it.

  • How much water should I drink with a catheter? 

You will need to drink a lot of water when you are with a catheter. This will help flush the bladder of mucus and keep the urine flowing. Drinking about 2-3 liters of water daily will help minimize blockage risk and urinary tract infection.

  • Is an augmentation cystoplasty painful?

Augmentation cystoplasty otherwise called bladder augmentation, which aims at improving the stretching ability of the bladder in other to hold more urine. You will need pain medications at least for a week or two to reduce and control the pain you may feel in your abdomen.