Complications after augmentation enterocystoplasty in children.

Abstract

Introduction: In the pediatric population, lower urinary tract dysfunction, usually, is due to neurogenic or anatomic defects. In this context, when conservative treatment fails, augmentation enterocystoplasty is a treatment option with good functional results. Nevertheless, multiple complications have been associated with this technique.

Methods: We conducted a retrospective review of the patients who underwent bladder augmentation surgery at our hospital over the past 25 years. Statistical analyses were performed to identify potential factors associated with the occurrence of complications.

Results: A total of 34 patients underwent augmentation enterocystoplasty during the study period. A total of 90 complications were recorded in 30 patients (88.2%). The average number of complications per patient was 2.6 ± 1.9. Reintervention was required in 28 patients (82.4%) due to complications, with a mean of 2.29 reoperations per patient. The most frequent complication was lithiasis (17/90), followed by stoma-related issues in the catheterizable duct (14/90), and urinary tract infections (10/90). Patients with exstrophy (p = 0.0028, IRR 3.4, 95% CI 1.71-6.78), bladder neck surgery (p = 0.014, IRR 2.04, 95% CI 1.29-3.21), and catheterizable duct (p = 0.002, IRR 2.56, 95% CI 1.61-4.06) had a significantly higher number of complications.

Conclusions: In our study, over 85% of patients who underwent bladder augmentation surgery experienced at least one complication during follow-up. The risk was significantly higher in patients with bladder exstrophy and in those who had a bladder neck procedure.