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Last updated: 02/17/2009

Purpose

Bladder dysfunction and incontinence may be due to problems with the reservoir capacity of the bladder or with the "gatekeeping" muscle (the sphincter), which, instructed by the brain, allows urine to build up or to be released. Bladder augmentation is used to treat serious and irreversible forms of incontinence and to protect the upper urinary tract (kidney function) from reflexia (urine back up to the kidneys). Many candidates for the surgery are highly compromised individuals with other serious conditions like spinal cord injuries and multiple sclerosis, as well as patients likely to undergo kidney transplantation. Patients who undergo bladder augmentation must be free of bowel and urethral disease and be able to perform self-catheterization (able to place a urinary tube into their urethra).


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Bladder augmentation is a surgical alteration of the urinary bladder. It involves removing strips of tissue from the intestinal tract and adding this to the tissue of the bladder. This has two intended results: increased bladder volume; and a reduced percentage of the bladder involved in contraction, that in turn results in lower internal pressures in the bladder during urination.

Risks of bladder augmentation include incomplete voiding of the bladder post-surgery (resulting in the patient having to undergo intermittent catheterisation or an indwelling catheter), acute intestinal obstruction due to adhesions some years after surgery, and, in extremely rare cases, cancers of the intestinal tissue within the bladder. It must be stressed that this risk is very small, and some specialists[weasel words] still regard the link to cancer as a theoretical one.


From http://en.wikipedia.org/wiki/Bladder_augmentation

Other Information

As a urologist, I've found it's easier to do the PSA test and then sit down with the patient and say here's what the results mean for you. Given what we know right now, that seems a very sensible approach.


-Dr. Evan Vapnek

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