GASTROCYSTOPLASTY - TECHNICAL AND METABOLIC CHARACTERISTICS OF THE MOST VERSATILE CHILDHOOD BLADDER AUGMENTATION MODALITY

The authors report on 23 patients who underwent complex continent urin ary reconstructions, made successful by the selection of gastrocystopl asty as the chosen augmentation modality. The mean patient age was 6.1 years, and the mean weight was 17.9 kg. The minimum follow-up period was 1.5 years. The bladder capacity increased from a preoperative mean of 77.8 +/- 52.2 (SD) mt to a postoperative mean of 303.5 +/- 117.4 m L (P <.000001). No adverse effects on renal function or serum electrol yte composition were encountered, and there were no instances of acido sis or alkalosis: Continence was achieved in 91% of patients. In two p atients (0.9%), hematuria-dysuria developed; one case was extremely mi ld. The other occurred only during a period of severe oliguria and res olved after transplantation. Gastrointestinal complications were minim al, Five patients had endstage renal disease at the time of reconstruc tion and have since had successful transplantation. Gastrocystoplasty is particularly applicable to the pediatric population because of its unique anatomic and metabolic characteristics, which bestow tremendous versatility. Copyright (C) 1995 W.B. Saunders Company