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The Urinary Tract  
The Urinary Tract

Copyright © Nucleus Medical Media, Inc.

Definition  

Bladder augmentation surgery increases bladder size. It can be done laparoscopically.

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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
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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:

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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, like:
    • Anti-inflammatory drugs
    • Blood thinners
    • Antiplatelets

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 four 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

Preventing Infection  

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  

Once you leave the hospital, do the following to help ensure a smooth recovery:

  • Take medications as directed.
  • Clean the incision areas with warm water and gentle soap.
  • Ask your doctor about when it is safe to shower, bathe, or soak in water.
  • If you have a catheter, follow the instructions for taking c