Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSPROCHA, Flavio TrigoBRUSCHINI, HomeroFIGUEIREDO, Jose AlaorMACHADO, Marcos GianettiGOMES, Cristiano MendesMASCARENHAS, FredericoSROUGI, Miguel2017-11-272017-11-272011JOURNAL OF UROLOGY, v.185, n.6, suppl.1, p.2576-2581, 20110022-5347https://observatorio.fm.usp.br/handle/OPI/22497Purpose: Most groups have reported disappointing results with autoaugmentation or detrusor myectomy for low capacity/compliance neuropathic bladders. Failure may be due to an ischemic diverticulum or mucosal shrinkage. We investigated whether a Silimed (R) silicone balloon placed in the bladder after autoaugmentation could prevent these problems, improving surgical results. Materials and Methods: We compared the results of standard bladder autoaugmentation in 12 children (group 1) with those in 10 (group 2) who underwent the same surgery using a bladder conformer. The conformer was a silicone balloon filled with saline that remained in the bladder for 2 weeks. All patients had a neuropathic bladder with poor capacity and compliance, resulting in urinary leakage between catheterizations. Preoperative and postoperative evaluation included a voiding diary, ultrasound, voiding cystourethrogram and urodynamics. Results: In group 1 only 1 patient became dry, 4 had little improvement in continence, 4 remained unchanged and 3 became worse. In group 2, 6 patients (60%) become continent without medication, 2 (20%) become continent with oxybutynin and 2 remained unchanged. Bladder capacity and compliance did not change significantly in group 1. However, in group 2 capacity changed from a mean of 140 to 240 ml and mean +/- SD compliance increased from 15.6 +/- 16.8 to 34.3 +/- 22.8 ml/cm H(2)O (p = 0.02). Conclusions: The inflatable balloon improved our long-term results of bladder auto-augmentation. A larger series may be necessary to confirm procedure efficacy and safety.engrestrictedAccessurinary bladder, neurogenicballoon dilatationmeningomyeloceleabnormalitiesurinary incontinenceearly clinical-experienceauto-augmentationmyelodysplastic childrenarticleCopyright ELSEVIER SCIENCE INC10.1016/j.juro.2011.01.029Urology & Nephrology