Introduction and objective: Assess the outcomes, safety, and the feasibility of laparoscopic augmentation ileocystoplasty for tuberculous (TB) contracted bladder by the first 11 cases. Patients and method: From January 2005 to December 2011, eleven patients suffering from TB contracted bladder underwent laparoscopic augmentation ileocystoplasty at the Department of Urology Band C of Binh Dan hospital. All patients received antituberculous drugs at least 2 months preoperatively. Four ports were used. Division of the middle umbilical ligament to enter the prevesical space. The contracted bladder is dissected off the paravesical adhesions and incised at the dome in a transverse incision slightly curved to the anterior aspect of the bladder. An ileal loop of 15 - 20 cm was isolated, exteriorized through an extended umbilical port incision of 4 - 5 cm, then detubularized and sutured into a cup-patch according to Goodwin. Intracorporeal vesico-ileal anastomosis was used to form a neobladder. the authors assess the operative outcomes in postoperative period and 6 months postoperatively. Results: There were 11 patients: 6 males and 5 females with mean age: 43.45 (27-61). Four cases (36.4 percent) with associated pulmonary tuberculosis, one case (9 percent) with epidydymal tuberculosis. Preoperative mean bladder capacity: 47.3 mL mL (40-50). Associated urinary tree deformities: bilateral ureteric strictures: 1/11 (9 percent), right ureteric stricture: 1/11 (9 percent), left ureteric stricture, bilateral vesicoureteral reflux (VUR): 1/11 (9 percent), right non-functioning kidney: 1/11 (9 percent), left non-functioning kidney: 8/11 (72.7 percent), bilateral VUR: 2/11 (18.2 percent), right VUR: 4/11 (36.4 percent), left VUR: 2/11 (18.2 percent). Four out of eleven cases (36.4 percent) had preoperative serum creatinin above 120 umol/L. Associated operative techniques: right neovesicoureteral reimplantation: 6/11 (54.5 percent), left neovesicoureteral reimplantation: 1/11 (9 percent), unilateral placement of a Double-J stent 2/11 (18.2 percent). Mean operative time: 430 minutes (330-480). Estimated blood loss: 480 mL (400-600). Conversion to open surgery: 3/11 (27.3 percent). Mean postoperative hospital stay: 11.9 days (6-20). Postoperative morbidity: one patient had bowel semi-occlusion in day 14 post-op which was managed conservatively, one patient had stricture of the neovesicoureteral reimplantation in a solitary functioning kidney one month postop necessitating a cutaneous ureterostomy. Followup at 6 months post-op (10 patients): mean bladder capacity (on VCUG): 252 mL (160-300), no VUR detected in all 3 patients having neovesicoureteral reimplantation, mean postvoiding residual urine: 58 mL (10-80). All patients had improvement of day-time and night-time urinary frequency and lower abdominal discomfort and/or pain. No cases of day-time and night-time urinary incontinence documented. Conclusion: By the 11 initial cases the authors realize that laparoscopic augmentation ileocystoplasty for TB contracted bladder is feasible, safe, and have satisfactory short-term functional and radiological outcomes. It could help to bring in advantages of MIS to the patients.
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