Laparoscopic Augmentation Ileocystoplasty: Results and Outcome

Background: Routine use of laparoscopic augmentation ileocystoplasty has not yet been established. Objectives: To assess the outcome of laparoscopic augmentation ileocystoplasty. Design, Setting, and Participants: Twenty-three patients underwent laparoscopic augmentation ileocystoplasty for hypocompliant bladder. Intervention: Bladder dissection and reconstruction of the ileovesical anastomosis were performed laparoscopically, whereas the ileal pouch was prepared extracorporeally through a small 3- to 4-cm muscle-splitting incision. Measurements: Patient data, operative details, and follow-up were recorded. Urodynamic evaluation was performed preoperatively and after 12 mo, taking the bladder capacity and the maximum detrusor pressure as a measure for the outcome of the procedure. Results and Limitations: All cases were completed laparoscopic ally, with a mean operative time 202 min; mean hospital stay 5 d, and mean urethral catheter duration 11 d. After 12 mo, the estimated bladder volume increased from a mean 111 ml to 788 ml (p < 0.01), whereas the maximum detrusor pressure dropped from a mean 92 cm H2O to 15 cm H2O (p < 0.01). During a mean follow-up of 39 mo, two long-term complications have been reported: bladder stone and spontanous rupture of the augmented bladder due to neglected clean intermittent self-catheterizaton. Conlusions: Laparoscopic augmentation ileocystoplasty is a safe procedure, technically feasible and with favourable urodynamic outcome. (C) 2008 European Association of Urology. Published by Elsevier B.V. All rights reserved.