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What is bladder augmentation?
Bladder augmentation is a surgical procedure to make the bladder larger so it can hold more urine at low pressure. This surgery helps protect the kidneys from damage that can happen when pressure inside the bladder is too high. Surgeons usually use pieces of intestine or stomach tissue to enlarge the bladder. After a bladder augmentation, the bladder needs to be emptied on a regular schedule throughout the day using a catheter.
Figure 1: Tissue is added to the bladder
Who benefits from bladder augmentation?
At Gillette Children's, bladder augmentation is performed most often on patients with a neurogenic bladder, a condition which affects how the bladder stores and empties urine.
A neurogenic bladder can cause the bladder wall to become too stiff and unable to stretch as it fills. When this happens, the pressure inside the bladder can become too high, which may lead to kidney damage and urine leakage.
Successful management of a bladder augmentation procedure depends on careful patient selection. Good candidates for a bladder augmentation procedure are those who are physically capable and emotionally ready to handle a strict routine of intermittent catheterization and daily bladder irrigation. Another good candidate is someone whose caregivers are motivated, available, and trained to follow the catheterization and irrigation routine.
What to Expect
You will do a bowel cleanout at home for 1 to 2 days before coming to the hospital. You will receive detailed bowel cleanout instructions from your surgical team before your procedure.
You will come to the hospital the day before surgery to finish cleaning out your bowels. A small tube called a nasogastric (NG) tube will be placed through your nose and into your stomach. This tube is used to give medicine that helps clean out your intestines.
Blood tests are done on the day of admission. An IV may be started to make sure that you get enough fluids. Antibiotics may be given through your IV as well. Your surgical team will give you specific instructions about what you can eat and drink and when to stop eating before surgery.
The surgery may take several hours. If you are having more than one procedure, it may take longer.
Following surgery, one or more catheters may be in place to keep the bladder empty and allow it to heal:
- Foley catheter: a tube inserted through the urethra into the opening at the bottom of the bladder.
- Suprapubic catheter: a tube inserted into the top of the bladder through the lower abdomen.
You will have an IV to give you medicine, fluids, and nutrition. Your incision will be covered.
After surgery, you will not be able to eat or drink anything by mouth. Within a few days, when bowel activity resumes, the NG tube will be removed, and your diet will advance slowly from clear liquids to full liquids to soft foods. This transition usually takes anywhere from three days to a week.
You can support healing by drinking plenty of fluids and eating nutritious foods.
Your care team may send you home when you eat a regular diet, take pain medicine by mouth, do not have a fever, and have returned to your usual activity level.
About two weeks after you leave the hospital, you will have a test called a cystogram. During this test, your care team will put contrast fluid, a special liquid that shows up on X-rays, into your catheter to fill your bladder. The test shows whether your bladder is healing well and checks for leaks.
If the test shows that your bladder is healing well and does not leak, your doctor may remove one or more catheters. Your doctor will decide which catheter(s) to remove and when to remove them.
Questions?
If you have questions or concerns, talk with your doctor or another member of your care team.
This information is for educational purposes only. It is not intended to replace the advice of your health care providers. If you have any questions, talk with your doctor or others on your health care team.
If you are a Gillette patient with urgent questions or concerns, please contact the Nurse Help Line at 651-229-3890.
The information on this page is reviewed by Gillette Children's medical editors for general educational purposes.
