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You may have had bladder augmentation mentioned to you by your urologist as an option for managing your continence. You may be offered this operation because you need to pass urine very often, or feel …

You may have had bladder augmentation mentioned to you by your urologist as an option for managing your continence. You may be offered this operation because you need to pass urine very often, or feel an urgent need to pass urine. You may have recurrent infections, and your urologist may be concerned about your kidney function. The operation is offered after other, less invasive treatments haven’t worked.

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  • 1. shinecharity.org.uk info@shinecharity.org.uk 42 Park Road Peterborough PE1 2UQ 01733 555988Bladder augmentationYou may have had bladder augmentation mentioned to youby your urologist as an option for managing your continence.You may be offered this operation because you need topass urine very often, or feel an urgent need to pass urine.You may have recurrent infections, and your urologist maybe concerned about your kidney function. The operation isoffered after other, less invasive treatments haven’t worked.The nerves which supply the of passing urine, and feelings ofbladder and bowel come from the needing to pass urine urgently.sacrum. As this is usually belowthe level of the spina bifida lesion, Furthermore the contractionsmost people with spina bifida will of the bladder may also nothave bladder and bowel problems coordinate with the sphincter(Neuropathic bladder/bowel). (the muscles around the bladder neck which keep the urine in theFor some people, especially those bladder, and open to let it passwith lumbarsacral lesions, the out of the bladder). If the bladderabnormality in the nerves to the muscle contracts against a closedbladder may cause it to contract sphincter, the urine in the bladderand twitch before it has been filled may be forced back up the ureterswith much urine, and the urine will (tubes which drain the urine from thebe stored at pressures too high to kidneys to the bladder) towards thebe safe. It will result in frequency kidneys, causing pressure damage
  • 2. Bladder augmentationto the kidneys. The bladder may reduced, so the high pressuresalso not empty fully if the emptying within the bladder, which can harmis uncoordinated; this will lead the kidneys, will be prevented.to recurrent urine infections, orbladder stone formation, putting After this surgery you will need tothe kidneys at greater risk. self-catheterise, even if you didn’t need to before, as the bladderAn operation, bladder will now not be able to contractaugmentation, has been used strongly enough to empty. Youfor a number of years now to may find a Mitrofanoff (a tubeimprove the situation for people opening the bladder on to thewith this type of bladder problem abdomen which you catheterise)(hyperreflexic bladder). By adding a better; if you have had problemspiece of clean small intestine, the catheterising in the past, becausebladder capacity can be increased it is too uncomfortable, or youand the tightness of the bladder can’t reach easily, talk to yourmuscle can be reduced. surgeon before your augmentation. Your surgeon may tighten up theA bladder augmentation operation bladder neck to prevent leaking ifis major surgery with a hospital stay you have a Mitrofanoff as well. Thisof around 10 days. The recovery will mean you need to rememberperiod is long too; expect not to feel to catheterise yourself regularly; iffully well for around three months. you are worried about forgetting toDuring the operation, your surgeon do this, talk to your surgeon beforewill make a cut along the top of the surgery. Talk to your continenceyour bladder, to form an opening adviser and Shine adviser too, aslike a clam shell (it is referred to as a there are aids such as vibratingclam cystoplasty). Into this space, wristwatches which can help.a length of your small bowel,which has been cleaned, will be Other complications?sewn to form a large patch, so thebladder will be larger and able to You may find that your augmentedhold more urine. The contractions bladder produces some mucus;of this altered bladder will also be this can be improved by bladder
  • 3. washouts – your urology team willguide you through this.There is a known but small riskof developing cancer in thebladder after this operation. Itwill be important for you to havecheck cystoscopies (telescopicexamination of your bladder) atsome stage to make sure everythingis alright.Remember, bladder augmentationis major surgery – expect a hospitalstay of 7-10 days. The recoveryperiod is long too; expect not to feelfully well for around three months.As with all major operations, makesure you understand what’s involvedand whether this is the right surgeryfor you – your surgeon, continenceadviser and Shine medical adviserare all there to help.
  • 4. Help usShine relies on people’s generosity and support so we can help our clientswho depend on us for help and advice - people with hydrocephalus, spinabifida, their families and carers. To donate to Shine please visitwww.shinecharity.org.uk or call 01733 421329.This information has been produced by Shine’s medical advisers andapproved by Shine’s Medical Advisory Committee of senior medicalprofessionals.Shine - Registered charity no.249338To see our full range of information sheets and to find out how to donateto Shine please visit