What is a bladder enlargement?

Bladder enlargement is a surgery that aims to increase the capacity of the bladder to better store urine. It is performed when the pressure in the bladder increases excessively when urine is retained, which occurs mainly in patients with very small bladders or bladders that have little capacity for stretching.

This increased pressure can cause urinary incontinence between catheterizations, urinary tract infections and progressive kidney damage. Without proper treatment, this can lead to kidney failure and/or the need for dialysis.

What does the surgery consist of?

The surgery consists of using part of the bowel as a patch to enlarge the bladder. It is performed by open surgery under general anesthesia and may take several hours.

How do I prepare for surgery? 

For surgery, it is necessary for the bowel to be as clean as possible. For this, only clear liquids are requested the day before surgery; usually, enemas are required to empty the bowel and antibiotics are prescribed before the procedure.

In some cases, along with this surgery, a Mitrofanoff - a conduit that connects the bladder to the abdominal wall to facilitate drainage and emptying - is installed.

What is the postoperative period like?

After surgery the patient is left with a nasogastric tube to drain the stomach during the postoperative period and one or two tubes to drain the bladder until the surgical wound heals. These tubes are removed before the end of the hospital stay or during follow-up visits.

Also during the first few days, it is necessary to have a zero feeding regimen. Gradually introduce feeding.

After bladder enlargement, it is mandatory to perform catheterizations to empty the bladder, since, due to its enlargement with a part of the bowel, the bladder loses its contractile capacity. Catheterization can be performed via the urethra or through the Mitrofanoff.

Initially, it is necessary to empty the bladder through a cystostomy catheter - a catheter that drains the bladder through the abdominal wall - until the patient is comfortable enough to begin catheterizations.

After the operation, is special care necessary?

The intestinal patch in the bladder enlargement produces mucus, so routine washings should be performed to avoid obstruction of the catheter and prevent urinary tract infections. These are known as bladder washings, which should be performed with saline or warm boiled water after emptying the bladder by catheterization.