Bladder Augmentation

Bladder augmentation is a complex reconstructive surgical procedure to increase the size of the organ and to improve its ability to stretch.

The bladder is a soft, stretchy, balloon-like organ where urine is stored until it is expelled from the body. In some children, the bladder is too small to hold the normal amount of urine produced by the kidneys, or it is very stiff and unable to fully expand to hold urine, resulting in urine leakage or urine back-up into the kidneys. Bladder augmentation can relieve urinary incontinence (wetting) and prevent damage to the kidneys from urine backing up.

The bladder is augmented using a portion of the intestine or the stomach. Boston Children's Hospital has also tested an experimental technique using tissue engineering to create laboratory-grown bladders from the child's own bladder cells.

When Boston Children's recommends bladder augmentation

Your child's physician may recommend bladder augmentation if your child has chronic obstructive bladder damage, birth defects, or any other medical problem that has made the bladder too small or too stiff to fully expand. Many children who need bladder augmentation have other serious medical problems, such as:

• spinal cord injuries
• spina bifida
• bladder exstrophy
• bladder obstruction
• multiple sclerosis
• kidney failure

How will my child's surgeon perform the bladder augmentation?

Bladder augmentation can be performed as a traditional open surgery, which requires a large incision on the abdomen. A portion of intestine or the stomach is attached to the bladder as a patch. The operation can also be done using minimally invasive techniques, the preferred technique at Boston Children's Hospital.

Surgeons at Boston Children's have recently completed an 18-month study to perfect a method for performing the procedure using state-of-the-art robotic surgery equipment. This minimally invasive approach significantly reduces pain, scarring, and recovery time for your child.

What are the complications associated with bladder augmentation?

Complications of bladder augmentation are similar to other surgeries. The procedure requires general anesthesia, and some patients can suffer headaches, nausea, or dizziness. Other risks include bleeding, infection, or rupture of the bladder. In some cases, your child's bladder may continue to leak after surgery, which could require an additional operation.

Finally, because the intestine is designed to absorb nutrients, while the bladder is designed to excrete, patients are prone to long-term complications, such as osteoporosis and stone formation and an increased risk of cancer.

What is the long-term outlook for a child who requires a bladder augmentation?

Bladder augmentation significantly improves the quality of life of most patients.

A few patients recover the capacity to urinate normally after bladder augmentation, but many others must learn to use a catheter to drain urine from the body.