doi: 10.1111/ijun.12079 REVIEW PAPER Bladder augmentation in children and young adults: a review of published literature Sarah Doyle, Bernie Carter, Lucy Bray and Caroline Sanders ABSTRACT The objective of this study is to review published literature on bladder augmentation in children and young adults (C&YA) with a neuropathic bladder following a neural tube defect or spinal cord injury to inform nursing practice and patient education. Medline, Embase, CINAHL, PsycINFO and the British Nursing Index were systematically searched to identify studies. The papers reviewed were case studies and medical note review in single centres regarding outcome and post-operative complications. This limits the generalisability of the findings surrounding outcome and risk of bladder augmentation surgery in C&YA. Evidence suggests irrigation has a role in ongoing bladder management to reduce complications such as bladder calculi. However, data are sparse regarding both appropriate irrigation solutions and the frequency of irrigation necessary to minimise calculi formation. A statistically significant increase is noted in the risk of perforation following bladder augmentation when associated with bladder neck surgery at the time of primary surgery. Limited evidence exists regarding longer term systemic implications of bladder augmentation, such as malignancy or impact on bone mineral density. None of the studies demonstrated an overall improvement in health-related quality of life (HRQoL) following bladder augmentation. Discrepancies exist between parental and children’s HRQoL scores. Bladder augmentation is clinically the standard surgical treatment used to manage refractory neuropathic bladder. However, current evidence demonstrates no improvements to HRQoL following surgery and also describes various complications. Future research in this area is necessary to explore standards of care and most importantly long-term outcome measures from the patient and professional perspective. Key words: Bladder augmentation • Children and young adults • Complications • Health-related quality of life • Neuropathic bladder • Review BACKGROUND The bladder’s function is to store an adequate vol- ume of urine at low pressure, empty to completion and therefore promote continence whilst protecting the Authors: S Doyle, RN(child), MSc, Advanced Paediatric Nurse Practitioner in Urology, Alder Hey Children’s NHS Foundation Trust and Lecturer, Edge Hill University, Liverpool, UK; B Carter, RSCN, SRN, BSc, PGCE, PhD, Professor of Children’s Nursing and Director of Children’s Nursing Research Unit, University of Central Lancashire & Alder Hey Children’s NHS Foundation Trust, Preston & Liverpool, UK; L Bray, BA, MSc, PhD, Senior Clinical Research Fellow, Children’s Nursing Research Unit, Alder Hey Children’s NHS Foundation Trust and Evidence-based Practice Research Centre, Edge Hill University, Liverpool, UK; C Sanders, BSc, PGDip, PhD, Consultant Nurse in Gynaecology and Urology, Alder Hey Children’s NHS Foundation Trust, Liverpool, UK Address for correspondence: S Doyle, Advanced Paediatric Nurse Practitioner in Urology, Alder Hey Children’s NHS Foundation Trust, Eaton Road, Liverpool, UK, L12 2AP E-mail: sarah.doyle@alderhey.nhs.uk upper renal tracts (Mast et al., 1995; Arikan et al., 2000). A lesion at any point of the neurological path- way can disrupt normal bladder function. A neuro- pathic bladder can be the result of a birth defect such as myelomeningocele, a spinal cord injury (SCI) or acquired post-viral infection such as transverse myeli- tis (Nomura et al., 2002). A neuropathic bladder is a lifelong condition requiring routine surveillance. Meth- ods of managing a neuropathic bladder can include regular intermittent catheterisation (IC), pharmacologi- cal treatments, medical management such as bladder Botox or surgical interventions such as a bladder aug- mentation. Bladder augmentation is often the surgical approach used when conservative medical or pharma- cological treatments of the bladder have failed and the goal is to facilitate a safe and continent urinary system (Chartier-Kastler et al., 2000; Nomura et al., 2002). Bladder augmentation most commonly involves using a gastrointestinal (GI) segment to enlarge the © 2015 John Wiley & Sons Ltd. and BAUN Int J of Urol Nurs 2015 1