Shall we talk about bladder augmentation surgery (Augmentation Cystoplasty)?

Do you have to urinate frequently? Or do you wet your clothes when you don't expect it? Sometimes, you may feel very uncomfortable due to things like bladder control and pain in that area. The cause of such problems may be a small bladder or increased pressure in it. In such cases, we are talking about a special surgery that doctors recommend today.

What is Augmentation Cystoplasty?

Simply put, this is a surgery to enlarge your bladder, the organ that stores urine in our body. Think of it like adding a little extra tissue to a small water balloon and making it bigger. In this surgery, the surgeon takes a small piece of your own small intestine or large intestine and uses it to enlarge your bladder. This is called `(Augmentation Cystoplasty)`.

Why do you need to have this kind of surgery?

Some medical conditions can impair bladder function. For example, spinal cord injuries, congenital nerve disorders , or conditions such as multiple sclerosis can cause bladder problems.

Here are some of the main reasons why this surgery may be necessary:

• Leakage: The loss of a small amount of urine without you even realizing it.
• Bladder spasticity : This means that the bladder muscles become involuntary and tense, causing a sudden, strong urge to urinate, uncontrolled urine leakage, or pain in or around the bladder.
• Reduced bladder capacity: Not being able to hold as much urine as before. Needing to urinate as soon as a little accumulates.
• Increased pressure in the bladder: This is a slightly dangerous condition. The bladder does not expand properly, which causes the pressure inside to increase significantly. This high pressure can cause urine to flow backward into the kidneys , leading to kidney infections and even kidney damage over time.

Most often, doctors recommend this surgery for those who have been urinating with a tube in place for a long time ( self-catheterization ).

What happens before the surgery?

Before deciding to have surgery, your doctor will examine you carefully. He or she may also perform several tests to make sure that this surgery is right for you.

You should definitely tell your doctor about any medications you are taking at this time, including prescription medications, over-the-counter medications, vitamins, and traditional medicines. Some medications, such as aspirin, can increase bleeding during surgery.

Let's talk about how the surgery is done.

This surgery takes about two to six hours. The doctor will perform this either through an incision in your abdomen (open surgery) or through a few small incisions using robotic surgery .

Simply put, this is what happens:

1. First, the top part of the bladder is cut open.

2. Then, a suitable piece of your small intestine or large intestine is cut and separated.

3. This piece of intestine is folded in the middle, forming a flat surface.

4. Finally, this piece of intestine is placed into the opening of the bladder that was cut out earlier and sewn up nicely.

When you wake up, you will have two or three tubes in your stomach and bladder. Don't worry, these are there to drain urine and clean the inside until your bladder heals.

What to expect after surgery?

You will need to stay in the hospital for about five to seven days after the surgery. You will not be allowed to eat or drink for the first few days. This is because after intestinal surgery, the intestines become inactive for a while. This is called 'ileus' . During this time, a tube may be inserted through the nose to drain any fluids that accumulate in the stomach. Once the intestines start working again, you will first be given liquid foods (e.g. soup water) and gradually introduced to regular foods.

If this is not done properly, this mucus can build up and form bladder stones , urinary tract infections (UTIs) , and even block the urethra. The nurses and doctors will teach you how to do this while you are in the hospital.

After about three weeks, a scan will be done to see if the bladder has healed well and is not leaking. If everything is fine, the doctor will remove the tube and teach you how to insert a tube and urinate yourself (self-catheterization).

What are the benefits and risks?

Like any surgery, this one has benefits as well as some risks.

How long does it take to heal?

After about six weeks, you will feel about 90% better. But it can take about three months to fully recover. During this time, you should stop lifting weights, running, playing sports, and having sex . Because if there is pressure on the abdomen, a condition like a hernia can occur.

It's important to follow your doctor's instructions exactly. You should be able to return to work or school after about six weeks, but that depends on the nature of your job and how quickly you recover.

When should I see the doctor?

Your doctor will give you a few days to come back, but if you have any of the symptoms below, you should call your doctor right away .

• Excessive bleeding from the cut.
• Fever (over 38°C Celsius or 100°F Fahrenheit).
• Infection, pain, or increased swelling at the incision site.
• If you are in severe pain or have any other unusual symptoms.