Bladder augmentation with detubularized intestinal segment.

The authors report on 9 cases of bladder augmentation with detubularized intestinal segments. The capacity of the contracted bladder was increased in 4 cases; care was taken to prevent the development of an hour-glass bladder. In a young female patient a caecal-ileal segment was applied so that in case of a possible future pregnancy the mesentery should not hinder the growth of the uterus. In 4 cases hypertonic neurogenic bladders were augmented with intestinal segments, thus the further destruction of the kidneys could be avoided. In one case the reflux was hindered by a Kock valve, but stagnation developed above the valve, therefore it was eliminated and replaced by a 15 cm intestinal segment. In one case the uninhibited neurogenic bladder was augmented, the resistance of the urethra increased as a result of which the patient stayed dry between self-catheterizations. Attention is called upon the metabolic disturbances and increased risk of infection following intestinal implantations.