Bladder augmentation

If you have Overactive Bladder or the symptoms of urge and urgency, you may wish to consider surgery if other more conservative treatments have not proved successful. Every person is different, and a surgeon will be able to discuss with you what exactly is causing your problem, and how surgery may help. Whatever your particular condition, it is important to really think through the pros and cons of having surgery.

If your doctor or nurse refers you to see a surgeon, then this is an ideal time to ask lots of questions. Ask your doctor as many questions as you want, and never be afraid to go back or telephone to get more information or a clearer explanation. Before meeting the surgeon it may help to note down your questions on a piece of paper, so you don’t forget what you wanted to ask. Make sure you write down the answers you are given; it’s easy to come out of a consultation and forget what has been said.

At any stage of the process if you are not clear about anything the doctor or surgeon says, ask them to explain again, a bit slower this time. The surgeon can also explain why they consider one operation particularly suitable for you over another.

Bladder Augmentation – this operation has several names:

  • Augmentation cystoplasty
  • Bladder augmentation
  • Clam cystoplasty
  • Ileocystoplasty
  • Bramble cystoplasty
  • Enterocystoplasty

This is a major operation indicated for Overactive Bladder and the symptoms of urge and urgency. It involves cutting open the bladder, like a clam, and sewing a patch of intestine between the two halves. The patch can be made of small intestine (ileocystoplasty), large intestine (sigmoid cystoplasty) or stomach lining (gastro cystoplasty). The aim of all of these is to increase bladder capacity and reduce the effect of the contractions of the bladder.

The operation will usually take 1 to 2 hours. After the operation a catheter is put in place. This is left in place for up to 7 to 10 days to keep the bladder empty while it heals. The average time needed in hospital after the operation is 10 days, but complete recovery can take 3 to 4 months.  Around two-thirds of all people who have this operation are cured, and three quarters are improved in some way.

The operation can cause extra problems, including:

  • The need to use a catheter – mucus from the patch of intestine can block the bladder outlet. As well as this, the enlarged bladder cannot contract strongly enough to push out all the urine. So most people who have this operation often have to use catheters to go to the toilet. This will be permanent, e.g for the rest of their lives.
  • Diarrhoea – since some of the bowel is cut out, diarrhoea and other bowel/nutritional problems can be caused.
  • Infections in the bladder – bacteria from the patch of bowel can cause recurrent infections in the bladder and urinary tract.
  • Bladder stones – this operation makes it more likely that people will develop bladder stones. Regular check-ups will make sure that these are spotted at an early stage.

If you would like more information about this procedure, please make an appointment with your GP who can discuss options with you.