Augmentation Cystoplasty (if reduced bladder capacity)
Bladder Enlargement Surgery to Treat Severely Reduced Bladder Capacity
What is Augmentation Cystoplasty (if reduced bladder capacity)?
Augmentation Cystoplasty increases the functional capacity of a severely reduced or overactive bladder by incorporating a detubularised segment of bowel (usually ileum) into the bladder dome. By enlarging the reservoir and reducing detrusor pressure, it significantly improves storage capacity and reduces nocturia, urgency, and incontinence. It is a major surgical procedure reserved for refractory cases where all conservative and medical treatments have failed. The procedure is performed under general or spinal anaesthesia with a hospital stay of 7–10 Days. Success rates reach >80% in appropriately selected patients at experienced centres.
How the Procedure Works
Bowel Segment Isolation
A 25–40 cm segment of terminal ileum or sigmoid colon is isolated on its vascular pedicle.
Bowel Detubularisation
The isolated bowel segment is opened along its antimesenteric border using diathermy, converting the tube into a flat plate.
Bladder Bivalving
The bladder is opened widely from dome to trigone in the sagittal plane, creating a 'clam' configuration to accept the bowel patch.
Bowel-Bladder Anastomosis
The detubularised bowel plate is sutured to the bivalved bladder with a running absorbable suture in two layers.
Dual Drainage & Closure
A urethral catheter and suprapubic catheter provide dual drainage for 3 weeks while the anastomosis heals; bowel continuity restored before abdominal closure.
Outcomes
Who Needs This Treatment?
- →Patients with a small, fibrotic, poorly compliant bladder from radiation cystitis or interstitial cystitis.
- →Those with neurogenic bladder from spinal cord injury, spina bifida, or multiple sclerosis causing severely reduced capacity.
- →Children with neuropathic bladder from spina bifida who face progressive upper tract damage from a hostile bladder.
- →Patients with refractory overactive bladder causing severe frequency and nocturia unresponsive to all medications.
- →Those willing and able to perform daily clean intermittent self-catheterisation post-operatively.
- →Patients with bladder capacity under 150 mL measured under anaesthesia failing all other interventions.
"Augmentation cystoplasty is a major but highly effective intervention for refractory bladder dysfunction. For the right patient with severely reduced capacity, it can be life-transforming."
— — Dr. Vipin Reddy, Consultant Urologist, Andrologist & Renal Transplant Surgeon
Common Questions
Frequently Asked
Not sure which treatment is right for you?
Book a consultation with Dr. Vipin Reddy and get a personalised treatment plan.