Augmentation ureterocystoplasty.

Augmentation cystoplasy using the gastrointestinal tract has disadvantages related to the intestinal resection and its incorporation into the urinary tract. To preclude both sets of complications, we performed augmentation ureterocystoplasty in a 5 1/2-year-old meningomyelocele patient with urinary incontinence, a low capacity bladder, severe vesicoureteral reflux and a poorly functioning kidney. After nephrectomy the ureter was incised longitudinally, folded over and placed onto the bladder as a patch. Bladder capacity, only 60 cc without the contribution from the refluxing upper tract, increased to 200 cc 6 months postoperatively. The patient is continent. Augmentation ureterocystoplasty is an option for bladder enlargement that obviates many of the risks associated with enterocystoplasty.