CPT® Code 51960

Enterocystoplasty, commonly known as bladder augmentation, is a surgical procedure that involves the use of a segment of the intestine to enlarge the bladder. This technique is particularly beneficial for patients suffering from bladder neuropathy and high-pressure detrusor contractions, conditions that can lead to significant urinary dysfunction. The primary goal of enterocystoplasty is to reduce intravesical pressure, thereby improving bladder capacity and function. The procedure begins with a cystoscopic examination of the bladder, which allows the surgeon to assess the bladder's condition and plan the surgical approach. During the operation, internal ureteral stents or external ureteral catheters are placed to ensure proper urinary drainage. Following the cystoscopic evaluation, a Foley catheter is inserted to facilitate urine management. The surgical approach involves a midline incision in the abdomen, through which the peritoneum is opened to access the abdominal cavity. The small bowel is then isolated and temporarily packed out of the surgical field to provide a clear view of the operative area. The ureters, which are the tubes that carry urine from the kidneys to the bladder, are carefully identified and protected throughout the procedure. A specific segment of the colon or ileum is selected for augmentation, which is then isolated and harvested. The remaining bowel segments are reconnected through anastomosis, restoring bowel continuity. The harvested intestinal segment is detubularized and reshaped into a graft, which can take on various configurations such as U-, S-, or W-shaped, depending on the surgical plan. The bladder is then bivalved to facilitate the attachment of the intestinal graft. In addition to the Foley catheter, a large-caliber suprapubic catheter is placed to ensure adequate urinary drainage postoperatively. Finally, the intestinal graft is sutured to the bladder, and drains may be placed as necessary before the abdomen is closed around the drains, completing the procedure.