Bladder augmentation for the treatment of chronic tuberculous cystitis. Clinical and urodynamic evaluation of 25 patients after long term follow-up

AIMS: Clinical and urodynamic evaluation of the late outcome of 25 patients with chronic tuberculous cystitis who underwent bladder augmentation. PATIENTS AND METHODS: Twenty men and five women with median age of 40 years were evaluated. The tubularized ileocecal segment was used in 8 cases, the detubularized sigmoid in 13, and the tubularized sigmoid in 4. Patients underwent a postoperative clinical and urodynamic evaluation. Miccional diurnal frequency of more than 2 hr together with patient satisfaction as assessed by the quality of life question of the ICSmaleSF questionnaire was considered a good result. RESULTS: The average postoperative follow-up was of 11.1 +/- 9.1 (1 to 36) years. A good result was seen in 80% of the patients. Bad results occurred statistically in the cases using tubularized sigmoid and in patients with prostatitis. Patients with good results showed augmented bladders with normal sensation (P = 0.03) and greater capacity (P < 0.01) and compliance (P < 0.01) than did those with bad results. There was no statistically significant difference in the frequency of involuntary contractions (P = 0.27) but in the good result patients, the contractions started with greater bladder filling volume (P = 0.02). CONCLUSIONS: The sigmoid should be detubularized but the ileocecal segment may be used in its original tubularized form to augment the bladder with chronic tuberculous cystitis. Augmented bladder with capacity of more than 250 ml, good compliance, and normal sensation are necessary for diurnal frequency of more than 2 hr. The presence of involuntary contractions does not lead to a decrease in the diurnal frequency.