Anterior flap extraperitoneal cystoplasty.

Abstract

We report on our initial experience with the anterior flap extraperitoneal cystoplasty for refractory voiding symptoms secondary to detrusor hyperactivity. A total of 27 patients underwent anterior flap extraperitoneal cystoplasty, the principles of which include a Pfannenstiel skin incision, a small peritoneotomy with minimal manipulation of the bowel, extraperitoneal bowel resection with ileovesical anastomosis and creation of an anterior bladder wall flap. Convalescence was uneventful in 25 patients (92%). Oral intake resumed on postoperative day 3 or 4, and the patient was discharged home on postoperative day 5 or 6. Voiding symptoms resolved or improved significantly in 92% of patients, who were dry or used 1 or no pads a day. Two complications required prolonged hospitalization. Anterior flap extraperitoneal cystoplasty is a safe and effective treatment that has the potential to decrease postoperative complications and recovery time.