Urothelium‐preserving augmentation cystoplasty covered with a peritoneal flap

Objectives To present the results of bladder autoaugmentation covered with a peritoneal flap in patients with bladder dysfunction. Patients and methods Thirteen patients (seven male and six female, mean age 11.9 years, range 4–25) who underwent autoaugmentation covered with a peritoneal flap were evaluated. Seven had different forms of myelodysplasia, four had spinal cord injury and two had Hinman syndrome as the cause of bladder dysfunction. Indications for augmentation included upper tract deterioration, urinary incontinence and recurrent urinary tract infection, despite anticholin‐ergic therapy. Results The mean bladder capacity increased by 18.6% after surgery and the mean compliance at capacity increased from 3.4 to 5.8 cmH2O/mL. All patients were incontinent before surgery and continence was achieved in only six afterward. Four patients showed no clinical or urodynamic improvement and required re‐augmentation using intestinal segments. Only three patients needed no anticholinergic therapy after surgery. All four patients in whom the procedure failed had capacities of