Urologists' Perception of Ureterocystoplasty: A Survey

Abstract

Furqan Ahmed and Paddy Dewan*

Introduction: Bladder augmentation remains a cornerstone of management for patients with a small, high-pressure bladder, often due to congenital or neurogenic etiologies. Ureterocystoplasty, using a di lated ureter, expands capacity without bowel incorporation risks; however, its clinical adoption remains limited due to the variable perspective on its indications and surgeon familiarity. Objective: To assess the current utilisation of, and attitudes towards, ureterocystoplasty compared to en terocystoplasty among urologists globally, to understand the surgeon experience, and barriers to a using a large ureter for bladder augmentation. Methods: A cross-sectional online survey was sent via email to pediatric urologists across the globe, through a professional network. The questionnaire, using ‘SurveyMonkey’, included four core elements, including the practice of ureterocystoplasty, the experience across urological units and indications for the procedure in the presence of a large ureter. Results: Seventy-three responded “Yes” to performing ureterocystoplasty for bladder enlargement, but 71% had only performed 5 or less, and only 8% have performed more than 20. If a large ureter was avail able, 35 (48%) support the use of a dilated ureter, 11 expressing inclusion criteria. Notably of the 40 re spondents who do perform ureterocystoplasty only 16 (40%) said they would perform the procedure when a large ureter was available. The data was also studied for the geographic location of the respondents. Conclusion: Our findings highlight the widespread lack of familiarity with ureterocystoplasty among urologists globally, thus highlighting the need for greater awareness and training to adopt a technique that has some advantages in specific circumstances.