AB058. Clinic practice of the laparoscopic ileal bladder augmentation

Objective: To investigate the efficacy and safety of laparoscopic ileal bladder augmentation in treating patients with low compliant bladder dysfunction.

Methods: From June 2011 to December 2013, 22 patients with low compliant bladder dysfunction were enrolled and received laparoscopic ileal bladder expanding. Postoperative complications, renal function, hydronephrosis, glomerular filtration rate, urodynamics parameters and quality of daily life were evaluated.

Results: The laparoscopic ileal bladder expanding were all successful. The average operation time was (105.0±16.7) min, the bleeding volume was (90.0±26.0) mL, the recovery time of intestinal function was (2.5±0.7) days, the hospitalization time was (15.0±4.2) days. All the patients had no serious complications, such as ileum anastomotic fistula, intestinal obstruction and abdominal infection or sepsis. Among them, 17 patients were followed up for more than 12 months. Compared with the preoperative condition, the average bladder capacity and bladder compliance were significantly increased from (103.0±38.2) cmH₂O to (403.0±45.8) cmH₂O, and from (9.6±3.1) to (38.1±4.4) mL/cmH₂O (P<0.001), respectively. And the average bladder pressure at the end of filling phrase of cystometry were significantly decreased from (45.3±15.8) cmH₂O to (16.5±6.4) cmH₂O (P<0.001). The preoperative and postoperative serum creatinine level were (183.5±32.2) μmol/L and (120±28.4) μmol/L (P<0.001), respectively. The preoperative and postoperative total glomerular filtration rate were (40.0±25.5) mL/min/1.73m² and (62.0±28.6) mL/min/1.73m² (P<0.05), respectively.

Conclusions: The operation of laparoscopic ileal bladder expanding is feasible and security, with the advantages of little injury, less bleeding, quicker recovery of intestinal function and less postoperative complications. The bladder function was obviously improved after operations, which can effectively protect the patient’s upper tract functions.

Keywords: Laparoscopic; ileal bladder expanding; low compliant bladder dysfunction; urodynamies