BLADDER AUTOAUGMENTATION BY VESICOMYOTOMY IN THE PEDIATRIC NEUROGENICBLADDER

Objectives. The authors describe the procedure of bladder autoaugmenta tion by vesicomyotomy in 1 2 pediatric patients with neurogenic bladde rs. Methods. Indications for augmentation included low-capacity, high- pressure bladders with incontinence despite maximal anticholinergic th erapy. Clean intermittent catheterization was successfully reinstitute d postoperatively and no patient has subsequently required enterocysto plasty. Results. There were no major complications and eight patients underwent concurrent procedures on the bladder. Urodynamic studies rev ealed a mean increase in capacity of 40% and a mean decrease in leak p oint pressure of 33% compared with preoperative values. Conclusions. E arly clinical experience would suggest that vesicomyectomy (excision o f released detrusor) offers no advantages over vesicomyotomy in pediat ric patients. Vesicomyotomy (simple incision into detrusor) proved to be a simple technique that could be safely performed in pediatric pati ents.