What is bladder augmentation?

Bladder augmentation, also known as cystoplasty, is a surgical intervention that is performed to enhance the capacity of the bladder by utilising a section of either the small intestine or the large intestine. The bladder is a balloon-shaped organ that is responsible for holding and passing urine. In a relaxed state, the bladder remains unfilled.

When the bladder reaches its full capacity, you will feel the need to urinate. At this point, the brain sends instructions to the bladder muscles, causing them to contract and exert pressure. Consequently, urine is expelled from the body through the urethra.

When is bladder augmentation indicated?

The bladder can be affected by various conditions, such as spinal cord injuries, congenital spinal or neurological issues, or acquired conditions like multiple sclerosis. These conditions can give rise to the following symptoms:

• Urine leakage
• Bladder spasticity is characterised by urgency, urge-related leakage, frequent urination, or discomfort in the bladder or genital area.
• Reduced bladder capacity, leading to a decreased ability to hold as much urine as before
• Impaired bladder muscle function, which may result in insufficient stretching of the bladder, leading to increased pressure. This increased pressure can potentially cause kidney infections and kidney damage.

In many instances, the urologist may recommend bladder augmentation following an extended period of self-catheterisation. Self-catheterisation involves the insertion of a thin, hollow tube called a catheter through the urethra to empty the bladder.

How is bladder augmentation performed?

Prior to undergoing bladder augmentation surgery, a series of examinations are conducted to assess the functionality and structure of the bladder and kidneys. These examinations may encompass blood tests, x-rays, and urodynamic studies to measure bladder pressure. After the surgery, similar tests may be performed to monitor the progress of bladder healing.

Bladder augmentation itself involves utilising a portion of either the bowel or stomach to expand the size of the bladder. The surgeon makes an incision in the abdominal region and opens the upper part of the bladder. A segment of the bowel or stomach is carefully removed and then attached to the top of the bladder as a patch, ensuring proper integration.