Long-term Outcomes of Augmentation Cystoplasty in Genitourinary Tuberculosis in Adults: A 12-year Follow-up Experience at a Tertiary Care Center.

ABSTRACT

OBJECTIVE: To evaluate the long-term effectiveness and consequences of augmentation cystoplasty in adult patients with small capacity bladder due to genitourinary tuberculosis (GUTB). METHODS: After approval of the institutional ethical committee, we retrospectively analyzed the database of adult patients with small capacity bladder due to GUTB treated by augmentation cystoplasty from January 2010 to December 2022 at our center. The patients were followed up at 6 weeks postoperatively, then every 3 months for first year and 6 months in second year, and then annually. Patients were assessed for symptoms, renal function, blood biochemistry levels, and ultrasound KUB at each follow-up visit. RESULTS: A total of 40 patients underwent augmentation cystoplasty were included. All patients underwent augmentation cystoplasty either with ileum (n = 35) or sigmoid colon (n = 5). On long-term follow-up, there was statistically significant improvement in bladder capacity, decrease in voiding frequency (P = .00), decrease in eGFR (P = .02) and increase in serum creatinine (P = .02). Significant complications were wound infection 4 (10%), intestinal obstruction 1(2.5%), urinary tract infection 6 (15%), bladder stone 2 (5%), mucus retention 3 (7.5%), hypocalcemia with metabolic acidosis 2 (5%) and need of intermittent catheterization in 11 (27.5%) patients. CONCLUSION: Multidrug therapy with judicious reconstructive surgery is the optimal treatment modality for GUTB with cicatrization sequelae. In GUTB, augmentation cystoplasty is a safe procedure and strict long-term follow-up is needed to prevent complications.