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Why is it done?

  • This procedure is seldom used today, with the more frequent use of Sacro-neuro-modulation and Intravesical BOTOX
  • This procedure is done to enlarge a bladder, especially in the spinal patient with a small contracted overactive bladder.
  • It can also be done as last resort in small overactive bladder after all other medical options have failed.


How is it done?

  • A General anaesthetic will be given
  • You would have had bowel preparation for 3 days prior to surgery.
  • A sterile surgical field is prepared
  • Prophylactic antibiotics are given.
  • An indwelling catheter is inserted and the bladder is then distended with fluid (saline).
  • A lower abdominal incision is made, splitting the linea alba.
  • A 15-20cm segment of the terminal ileum is isolated and removed from the rest of the intestinal tract on its vascular pedicle.
  • A watertight anastomosis of the bowel ends are done and tested.
  • The bladder is then bi-valved.
  • The 15cm of ileum is opened on the anti-mesenteric edge and the bowel in cleaned.
  • The ileum-segment is then sewn on to the bi-valved bladder.
  • A 3-way catheter is placed
  • A drain is left.
  • The abdomen and skin is closed
  • A catheter will be left for 2 weeks




  • Rarely blood loss requiring a blood transfusion.
  • Infection, Peritonitis.
  • Faecal leak from small bowel anastomosis
  • Prolonged hospital stay.
  • Urine leak requiring prolonged catheterisation,.
  • NB! Each person is unique and for this reason symptoms vary!


What next?

  • You will spend up to 5-7 nights in hospital.
  • You will have a catheter for 14 days.
  • A drain for 2-3 days.
  • You will be discharged as soon as you are drain free, temperature free and have opened your bowels.
  • You may initially suffer from urge symptoms caused by the catheter.
  • There may be some blood in your urine. You can remedy this by drinking plenty of fluids until it clears.
  • A ward prescription will be issued on your discharge, for your own collection at any pharmacy
  • A follow-up appointment will be scheduled for 2 weeks for a cystogram.
  • Should the cystogram confirm to urine leaks, your catheter will be removed.
  • A review appointment is scheduled 6 weeks later
  • Don’t hesitate to ask Jo if you have any queries


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Copyright 2019 Dr Jo Schoeman