Long-term followup of the hematuria-dysuria syndrome

Purpose: The hematuria-dysuria syndrome is the most common reported complic ation of gastrocystoplasty. We reviewed our cases of gastrocystoplasty to d etermine the long-term incidence and significance of the syndrome. Materials and Methods: We performed a retrospective study of 78 patients wh o underwent gastrocystoplasty at our institution between July 1989 and Octo ber 1994. A total of 72 of the 78 cases were evaluated within the last year to elicit symptoms of the hematuria-dysuria syndrome. Results: Spina bifida and bladder exstrophy were the most common diagnoses of patients undergoing gastrocystoplasty. There were 3 (4%) patients who re quired medications on a continuous basis to control symptoms of the hematur ia-dysuria syndrome. However, using broad criteria 17 (24%) patients would be categorized as having the syndrome. Of these patients 9 did not require any medications and 4 occasionally took medications to control symptoms. A significant increase in the incidence of the hematuria-dysuria syndrome was detected in those cases with a sensate compared to those with an insensate urethra. Conclusions: The hematuria-dysuria syndrome is a clinically significant pro blem at long-term followup in a small percentage of patients treated with g astrocystoplasty. The lowest incidence is in those children with an insensa te urethra who are continent. When symptoms occur they are easily treated i n the majority of cases. We believe that gastrocystoplasty remains a viable option in the armamentarium of bladder augmentation.