A new approach to bladder augmentation in children:: seromuscular enterocystoplasty

Objective. To report the use of seromuscular enterocystoplasty (SE) combined with detrusorectomy, in children. Patients and methods. Between 1993 and 1998, SE was performed in 10 children (aged 10-17 years) with a spastic neurogenic bladder resulting from spinal trauma. Before surgery all children were incontinent and despite anticholinergic medication and clean intermittent catheterization, their bladder capacity was 60-100 mL and their intravesical pressure 40-60 cmH(2)O. Results. Before surgery, the mean end-filling intravesical pressure was 47.7 cmH(2)O and the mean bladder capacity 82.9 mL. At 3 months after surgery the mean end-filling intravesical pressure was decreased to 21.1 cmH(2)O and the mean bladder capacity increased to 319.6 mL. One patient (a 14-year-old girl) had urinary retention soon after surgery and has since used clean intermittent catheterization. The other children were able to void successfully using the Valsalva manoeuvre; none were incontinent. All patients were followed and there were no changes in intravesical pressure and bladder capacity. Conclusion. In providing most of the desired features of an ideal augmentation segment, SE is a good and effective method of bladder augmentation.