Monday, March 11, 2013

Augmentation Cystoplasty (part 7)


The patient should be seen for follow-up visits at 6 weeks, 3 months, and 6 months, then yearly thereafter. The focus is on preventing complications by monitoring with appropriate laboratory and radiologic studies.
Serum electrolytes and renal panel should be monitored to assess the level of acidosis and the potential need for correction with alkali therapy. Renal and bladder ultrasonography is used to monitor for occult obstruction or calculi formation and to confirm appropriate renal growth in pediatric patients.
Screening urine culture tests are used to check for bladder colonization with urease-producing bacteria; these species should be treated because they may cause bladder stones and have been associated with upper tract damage.
Begin bladder malignancy screening 10 years after surgery with annual cystoscopy, cytology, and biopsy if appropriate. Educate the patient about the symptoms of bladder perforation and the need for urgent treatment.

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