Enterocystoplasty: the star modification.

Abstract

A modification of sagittal cystoplasty is described that maximally reconfigures the native neuropathic bladder, as required in enterocystoplasty. The star modification incorporates lateral cystotomies with anteroposterior cystotomy, as in the widely used sagittal clamshell technique. Enterocystoplasty was performed in 27 patients with various bowel segments using this technique and none has had complications attributable to cystoplasty after a mean followup of 2.5 years. Star reconfiguration defunctionalizes any potential noncompliant or hyperreflexic tendencies inherent to the neuropathic bladder before augmentation. In addition, the modification provides a technical advantage by increasing the linear length of the edge available for the anastomosis of bowel to bladder.