What is Bladder Augmentation?
The bladder's job is to store urine and release it when it's full. It is one of the many organs located in the lower part of your abdomen. Sometimes the bladder isn't large enough to hold the usual amount of urine made by the kidneys, so a bladder enlargement or augmentation may help.
What Happens under Normal Conditions?
The urinary tract is like a plumbing system with special 'pipes' for water and wastes to flow through. The urinary tract is made of the kidneys, 2 ureters, the bladder, and the urethra.
The kidneys act as a filter system for the blood. They remove toxins and keep the useful sugar, salts, and minerals. Urine is the waste product made by the kidneys. It flows from the kidneys down two, 10 to 12-inch-long tubes called ureters into the bladder.
The bladder is a balloon-shaped organ that stores urine. It's held in place by pelvic muscles in the lower part of your belly. When it isn't full, the bladder is relaxed. Nerve signals in your brain let you know that your bladder is getting full. When full, you feel the need to urinate. The brain tells the bladder muscles to squeeze (or “contract”). This forces the urine out of your body through your urethra.
Your urethra has muscles called sphincters. They help keep the urethra closed so urine doesn't leak out before you're ready to go to the bathroom. These sphincters open up when the bladder contracts.
What is Bladder Augmentation?
In some people, the bladder isn't large enough to hold the urine made by the kidneys. Urine may leak from the bladder.
In others, the bladder muscle may lose its ability to stretch ("expand"). If this happens, pressure in the bladder can build up. This can keep urine from draining properly. Sometimes the pressure can push the urine back up through the ureters into the kidneys ("reflux").
Either of these conditions can cause wetting ("incontinence"), urinary tract infections, or kidney damage.
Bladder augmentation is an operation to make the bladder larger. It can also lower the pressure in the bladder and make it more elastic.
Before bladder augmentation surgery, tests are done to measure bladder and kidney function and structure. These tests may include blood tests , x-rays , and bladder pressure studies (urodynamics). The same tests may be done after surgery to make sure the bladder is healing.
During surgery, a section of the bowel or stomach is used to make the bladder larger. The surgeon makes a cut in the belly and opens the top of the bladder. A section of the bowel or stomach is cut out and sewn onto the top of the bladder as a patch.
After bladder augmentation, the bladder may not be able to naturally release the stored urine. Most patients must learn to pass a catheter through the urethra or through a specially created opening into the bladder. This catheter allows the bladder to empty completely. This is called "clean intermittent catheterization" (CIC). After surgery, it's important to do CIC regularly so the bladder doesn't stretch too much or tear.
How do I Prepare for Surgery?
A few days before surgery, you may need to start a low fiber diet and start taking antibiotics to prepare the bowel. Your health care provider may tell you to only drink clear liquids the day before surgery.
What is a Bowel Prep ("Clean Out")?
"Bowel prep" refers to cleaning the bowel by drinking a special liquid. During this clean-out process, you'll have several loose stools. The bowel prep is finished when the stools are clear and watery. This process can help prevent infection during surgery.
When Can I Eat and Drink after Surgery?
For a few days after surgery you'll get fluids, "food," and medicines through an IV tube in your arm. Your health care providers will listen to your belly for "gurgle" sounds each day. You'll usually be ready to start eating soon after the lower belly starts making sounds again. You'll start with clear fluids, and will soon be able to eat regular food again.
When Will I Be Able to Return to School or Work?
Most patients are ready to return to their regular activities within a few weeks after leaving the hospital. However, each person is different, and recovery may take as long as three to four weeks.
Source: Urology Care Foundation.