(Augmentation, Bladder—Laparoscopic Surgery; Augmentation Cystoplasty—Laparoscopic Surgery; Cystoplasty, Augmentation—Laparoscopic Surgery)
Definition
Definition
Bladder augmentation surgery increases bladder size. It can be done laparoscopically.
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Reasons for Procedure
Reasons for Procedure
Bladder augmentation surgery makes the bladder large enough to collect urine. When the bladder is too small, it can cause urine to leak out of the body (incontinence) or back up into the kidneys (reflux). This can cause a kidney infection and damage the kidneys. This procedure is used to treat serious cases of incontinence after other treatments have failed.
Birth defects and other conditions, like chronic obstructive bladder damage, can cause the bladder to be too small.
Surgery may also be done if you have:
- An overactive bladder—bladder muscle contracts when it does not need to, causing urine leakage
- A neurogenic bladder—problems with nerve signals leading to the brain and muscles, causing urine leakage or retention
Possible Complications
Possible Complications
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Excess bleeding
- Reaction to anesthesia
- Infection
- Blood clots
- Nausea and vomiting
- Bladder rupture
- Abdominal pain
- Switching to open surgery
- Urinary incontinence—may be temporary or require more surgery to fix
- Increased risk of kidney stones
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications, such as:
What to Expect
What to Expect
Prior to Procedure
Your doctor will:
- Order tests, such as blood and urine tests, x-rays, ultrasounds, and bladder pressure studies.
- Talk to you about your medications. You may be asked to stop taking some medications up to one week before the surgery.
Before surgery, your doctor may recommend that you:
- Eat a low-fiber diet.
- Take antibiotics.
- Cleanse your bowel—You will drink a special liquid that causes loose stool. The liquid may be given through a tube placed in the nose down to the stomach.
Anesthesia
General anesthesia will be used. It will block pain and keep you asleep.
Description of the Procedure
The doctor will make several small, keyhole incisions in the abdomen. A laparoscope will be inserted. This gives the doctor a clear view of the inside of the abdomen.
An incision will be made on the top part of the bladder. The doctor will use tools, like clips and staplers, to remove a piece of the intestine or stomach. After this piece is cut out, a suturing device will be used to close the incision. Next, the doctor will attach the piece of the intestine or stomach to the bladder.
In some cases, the doctor will also create a stoma. This is a small opening through the abdominal wall to an opening that is made at the top of the bladder. These openings will make it easier for you to insert the catheter into the bladder.
Depending on the method your doctor uses, a combination of open and laparoscopic procedures may be done. If you do need open surgery, you will have a larger incision and a longer recovery time.
Immediately After Procedure
A catheter will be left in place to drain urine from the bladder.
You may be given fluids, pain medications, and antibiotics through an IV. A tube will be placed through your nose to your stomach. This tube will keep your stomach drained of any contents. This will stay in place until your stomach and intestines begin working normally again.
How Long Will It Take?
About 4 hours
How Much Will It Hurt?
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
Average Hospital Stay
The usual hospital stay is 3-5 days. If you have any problems, you will need to stay longer.
Post-procedure Care
At the Hospital
After your procedure, the hospital the staff will:
- Give you fluids and nutrients through an IV—You will not be able to eat until your intestines are working normally. This may take several days. When you are ready, the tube in your nose will be removed. You will begin to take fluids by mouth. You will slowly progress to soft foods.
- Have you take deep breaths to keep your lungs clear.
- Encourage you to walk.
- Teach you how to insert the catheter through the urethra or through the stoma—Depending on your recovery, the catheter that was placed during surgery may be removed before you go home. If so, you will be taught how to catheterize yourself at home using a tube.
- Teach you how to irrigate the bladder using a salt water solution and a catheter
During your stay, the hospital staff will take steps to reduce your chance of infection, such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
There are also steps you can take to reduce your chance of infection, such as:
- Washing your hands often and reminding your healthcare providers to do the same
- Reminding your healthcare providers to wear gloves or masks
- Not allowing others to touch your incision
At Home
To help ensure a smooth recovery:
- Take medications as directed.
- Clean the incision areas with warm water and gentle soap. Monitor the area for signs of infection.
- If you have a catheter, follow the instructions for taking care of it. You may see bloody urine for a few weeks.
- If you are catheterizing yourself, carefully follow the guidelines for emptying your bladder.
- Irrigate the bladder as directed. This is especially important if you have a piece of the intestine attached to your bladder. The intestine patch will continue to make mucus. This can clog the catheter tube.
Call Your Doctor
Call Your Doctor
It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:
- Signs of infection such as fever and chills
- Redness, swelling, increasing pain, bleeding, or discharge from the incision and/or stoma site
- Nausea and/or vomiting
- Abdominal pain
- Little urine output, extreme cloudiness, pus in the urine, or a bad odor to the urine
- Difficulty with catheterizing or irrigating
If you think you have an emergency, call for medical help right away.
RESOURCES:
Urology Care Foundation http://www.urologyhealth.org
CANADIAN RESOURCES:
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http://www.chrp.org/empowering/cs.shtm
Accessed August 8, 2013.
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Last Updated: 5/28/2014