Dp. Poppas et al., LAPAROSCOPIC LASER-ASSISTED AUTO-AUGMENTATION OF THE PEDIATRIC NEUROGENIC BLADDER - EARLY EXPERIENCE WITH URODYNAMIC FOLLOW-UP, The Journal of urology, 155(3), 1996, pp. 1057-1060
Purpose: We report our initial experience with laparoscopic laser assi
sted bladder auto-augmentation for treatment of the symptomatic pediat
ric neurogenic bladder. Materials and Methods: Laparoscopic auto-augme
ntation of the bladder was performed in 2 children with myelodysplasia
and high pressure neurogenic bladders unresponsive to medical managem
ent. Detrusorotomy was done using the KTP-532 laser. Laser energy was
directed to the tissue using a backstop laser delivery device. Both p
atients were followed with urodynamic studies to evaluate long-term ef
fects of the procedure. Results: Laparoscopic bladder auto-augmentatio
n can be performed easily and with less morbidity-compared to open aut
o-augmentation. Although results at 6 weeks showed improvement, entero
cystoplasty was ultimately performed in both cases due to symptomatic
recurrence of incontinence associated with increasing peak detrusor pr
essure and decreasing compliance. Conclusions: While this technique ha
s the potential to offer minimally invasive correction in patients: wi
th low capacity, high pressure bladders, further modifications will be
required to achieve long-term success.