Orthotopic neobladder includes ileal cystoplasty (Studer bladder, M-shaped ileum bladder), sigmoid cystoplasty, cecal cystoplasty, and gastrocystoplasty
. Orthotopic ileal cystoplasty accounts for 39-74% of orthotopic neobladder.[sup] The incidence of urinary incontinence after receiving an orthotopic neobladder by day is 8-10% while it is 20-30% at night.[sup] Continence is affected by the different types of surgeries.
I have read with great interest the case report by Ozcan et al, describing the case of a male bladder exstrophy patient after gastrocystoplasty
. After a long history of bladder perforation, acid haematuria syndrome, recurrent urinary tract infections finally he received a cadaveric renal transplantation.
Helicobacter Pylori was previously demonstrated at gastric patch after gastrocystoplasty and a possible relationship with acid-haematuria syndrome was established after symptomatic relief by medical treatment.
Keywords: Cancer, Gastrocystoplasty, Helicobacter pylori, Peptic ulcer, Renal transplantation.
Gastrocystoplasty may be considered in patients with renal insufficiency and short lenght of bowel.
Transureteroureteostomy, ureteroneocystostomy, gastrocystoplasty and epispadias repair was performed at 4 years of age after failed repairs.
We documented Helicobacter Pylori at the gastric part of bladder in patients suffering from haematuria-dysuria syndrome after gastrocystoplasty. Subsequently, this patient was re-evaluated for this relationship at 9 years of age.
Acid haematuria syndrome is a common complication after gastrocystoplasty. We established a relationship between Helicobacter Pylori infection and acid haematuria syndrome by demonstration of Helicobacter Pylori in the gastric patch and disappearance of symptoms after medical treatment.1 Since, Helicobacter Pylori is common in general population, we recommend routine Helicobacter Pylori investigation before gastrocystoplasty and medical treatment if presents.
We observed the persistence of Helicobacter Pylori in the gastric patch in the long term follow up of a patient with gastrocystoplasty who had a past history of severe intermittent acid haematuria syndrome responding to medical treatment and bladder perforation.6,7 In our clinical practice, once we achieve the disappearance of symptoms we do not perform a redo biopsy of gastric patch to detect Helicobacter Pylori.
Atrophic gastritis was found in biopsy samples after gastrocystoplasty.9 Malignant transformation may develop after gastrocystoplasty in the long term follow-up.9-11 The presence of Helicobacter Pylori in the gastric patch may be important as, a predisposing factor for gastric atrophy.