If you live with a neurogenic bladder, a procedure called augmentation cystoplasty may help you maintain independence. In the video above, Dr. Rose Khavari explains who might benefit from bladder augmentation and how it works.
When is bladder augmentation needed?
Certain health conditions that affect the brain, spinal cord or nervous system, like multiple sclerosis (MS), Parkinson's disease and stroke, can cause the bladder to become small, contracted and unable to hold enough urine. This leads to urine backing up into the kidneys, which can cause kidney damage. Or, the urine may get pushed out, resulting in leakage and incontinence.
"When medications or bladder Botox fail, we actually have to make the bladder bigger — and that's called an augmentation cystoplasty," says Dr. Khavari.
How does augmentation cystoplasty work?
For patients who are comfortable draining urine via self-catheterization, Dr. Khavari might recommend using a part of the patient's own bowel to enlarge the bladder.
"Instead of needing to use the restroom every hour or two hours, they can actually sleep through the night," Dr. Khavari says. "They can hold it for five hours, six hours without have any accidents."
If a patient is unable to self-catheterize, a urologist may suggest a Mitrofanoff procedure, also known as a Mitrofanoff appendicovesicostomy. The surgeon uses a small piece of bowel or the appendix to create a "chimney" for easier access to the bladder.
"We'll attach one end to the bladder, and the other end to the belly button or the side of the abdomen," says Dr. Khavari. "They can self-catheterize easily without even getting out of their wheelchair. It can bring a lot of independence and comfort."
