Augmentation ureterocystoplasty could be performed more frequently

Purpose: Megaureter represents the ideal tissue for bladder augmentation bu t to date ureterocystoplasty has been used only in select cases. We demonst rate that ureterocystoplasty can be used more frequently by dividing the me gaureter and using its distal part for bladder augmentation and proximal pa rt for reimplantation into the bladder. This technique can be performed as a 1 or 2-stage procedure. Materials and Methods: From November 1995 to October 1998 ureterocystoplast y was performed in 16 patients 3 to 12 years old (mean age 6.6). In 9 cases with impaired renal function loop cutaneous ureterostomy had been previous ly done to preserve and improve renal function. In the remaining 7 cases bl adder augmentation and simultaneous ureteroneocystostomy were performed wit hout cutaneous ureterostomy. Ureterocystoplasty was done extraperitoneally. This distal part of megaureter was used for bladder augmentation and the p roximal part was implanted into the bladder using extravesical detrusor tun neling ureteroneocystostomy in a majority of cases. Results: Followup ranged from 12 months to 4 years (mean 2.8). The new incr eased bladder capacity ranged 296 to 442 mi. (mean 371) in both groups. Com pliance was improved in all cases with a decrease in the number of clean in termittent catheterizations daily, and there was no further worsening of re nal function. Vesicoureteral reflux was noted in 3 patients without clinica l symptoms. Conclusions: Megaureter presents the ideal tissue for bladder augmentation. Division of the ureter and use of its distal part for augmentation is alwa ys possible. Augmentation ureterocystoplasty performed this way can be done more frequently.