علاج سل الجهاز البولي مع المثانة المنكمشة (السعة 20–100 مل)

References

DOI: 10.1590/S1677-5538.IBJU.2024.0590

In patients with bladder tuberculosis, bladder augmentation with an intestinal segment is indicated when the bladder capacity is less than 100 mL (GRADE: moderate, strong).

In patients with very small bladders (capacity less than 20 mL) or in those with UGT associated with pelvic pain, cystoprostatectomy and an orthotopic neobladder may be considered (GRADE: very low, weak).

When bladder augmentation or orthotopic neobladder surgery is performed, the ileum, sigmoid and ileocecal segments can be used. Detubularization and reconfiguration of the intestinal segment should be performed, but the ileocecal segment can be used in its original form without detubularization (GRADE: low, weak).

Ureteral reimplantation is indicated in patients with ureteral stricture but may not be performed in patients with reflux (GRADE: low, strong).

In this study, good results (voiding interval greater than or equal to two hours) were associated with the use of an ileocecal segment without detubularization and a sigmoid segment with detubularization.

Spontaneous voiding occurs in most patients after bladder augmentation.