LAPAROSCOPIC LASER-ASSISTED AUTO-AUGMENTATION OF THE PEDIATRIC NEUROGENIC BLADDER - EARLY EXPERIENCE WITH URODYNAMIC FOLLOW-UP

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.