Bladder Augmentation

1. What is Bladder Augmentation?

Bladder augmentation, also called augmentation cystoplasty, is a type of major reconstructive surgery that increases the size of the bladder and lowers internal pressure. To do this, the surgeon uses a small piece of intestine, most often from the small bowel, and attaches it to the existing bladder.

The intestinal tissue forms a soft patch that expands the bladder’s capacity so it can hold urine at a lower pressure. This approach may help relieve certain urinary symptoms and reduce the risk of kidney strain in selected patients.

2. Why is this surgery performed?

This operation may be considered when the bladder cannot store urine safely or comfortably. Common reasons include:

• Neurogenic bladder, a condition in which nerve damage, such as from spinal cord injury, spina bifida, or multiple sclerosis, interferes with normal bladder function.
• Severely overactive bladder that does not improve with medication or other conservative measures.
• Bladder scarring or reduced capacity due to prior inflammation, infection, or surgery.
• Protection of kidney function when high bladder pressure could cause lasting strain on the urinary system.
• Severe urinary incontinence related to a small or high pressure bladder that has not responded to other available treatments.

3. What happens before surgery?

Before surgery, your healthcare team performs a thorough evaluation to confirm that bladder augmentation is appropriate and safe.

• Urodynamic testing measures how well the bladder stores and empties urine, helping tailor the surgical plan to your needs.
• Imaging studies review the structure and condition of the kidneys and bladder.
• Kidney function testing checks overall kidney health.
• Bowel evaluation ensures the intestinal segment to be used is healthy.
• Discussion about catheterization helps you understand whether long term or intermittent self catheterization may be required.
• Preoperative counseling covers expected mucus production from the intestinal tissue and explains the importance of ongoing follow up after surgery.

4. What happens during surgery?

Bladder augmentation is performed through an open incision in the lower abdomen.

• The bladder is opened to prepare for enlargement.
• A small segment of intestine is separated and reshaped into a patch.
• This intestinal patch is attached to the bladder to create a larger reservoir for urine.
• Catheters are placed to help the bladder heal properly after the procedure.

The length of surgery can vary depending on individual anatomy and previous operations.

5. What to Expect After Surgery

In the hospital

• Pain control is provided to support recovery.
• The bowel may temporarily slow down before returning to normal activity.
• Eating resumes gradually as tolerated.
• Catheters remain in place while the bladder heals.
• A hospital stay often lasts about one to two weeks, depending on recovery progress.

At home

• You will receive detailed guidance on caring for your catheters.
• Some people learn intermittent self catheterization, if needed, for complete bladder emptying.
• Increasing fluid intake is often encouraged, but the exact amount should be discussed with your care team based on your individual health.
• Mucus may appear in the urine; your team will review how to manage and monitor this.
• Scheduled follow up visits allow the surgical team to assess healing and long term bladder function.

6. Risks and Possible Complications

All major surgeries carry risks, and individual outcomes vary.

General risks

• Bleeding
• Infection
• Blood clots

Procedure specific risks

• Urine leakage from the joined area
• Bowel obstruction from intestinal handling
• Increased mucus production from the intestinal patch
• Ongoing need for intermittent catheterization to fully empty the bladder
• Possible electrolyte imbalances from absorption changes in intestinal tissue
• Formation of bladder stones over time
• Rarely, concerning tissue changes, malignancy, in the augmented area
• In some cases, the need for additional surgery

7. Long Term Considerations

Bladder augmentation requires lifelong medical follow up. Regular monitoring helps protect urinary tract health and identify any issues early.

• Ongoing checks of kidney and bladder function
• Assessment of the intestinal patch and bladder wall
• Review of catheterization technique or frequency, if used
• Guidance on maintaining hydration and daily care routines

Many patients adapt well over time, though the augmented bladder generally requires continued attention to avoid complications.

8. When to Seek Urgent Help

Contact your healthcare provider or emergency services promptly if you experience:

• Fever or chills
• Severe or increasing abdominal pain
• No urine output from catheters
• Cloudy urine, strong odor, or other signs of infection
• Inability to catheterize or drain the bladder

9. Disclaimer

This information provides a general overview of Bladder Augmentation (Augmentation Cystoplasty). It is not a substitute for medical advice, diagnosis, or treatment. Your individual care plan may differ. Always follow the recommendations of your treating clinician.