A 23-year-old male diagnosed with hyperlexic bladder secondary to myeloomeningocele.
He had a ventriculoperitoneal shunt due to hydrocephalia.
Despite medical treatment, the patient presented symptoms of total urinary incontinence, requiring penile collector, as well as recurrent pyelonephritis, predominantly on the right side.
The cystography showed the presence of a bladder with a scalloped contour, low capacity with passive vesicoureteral reflux grade III right and active grade I left.
Cystography data were confirmed by urodynamic study.
Laparoscopic widening enterocystoplasty was performed with a 15 cm desubularized ileal segment. The duration of surgery was 6 hours.
The bleeding was about 100 cc.
The postoperative course was uneventful and the patient was discharged on the ninth postoperative day.
After 18 months of follow-up the patient is continent and has not had new episodes of pyelonephritis.
Cystography performed 6 months after surgery showed disappearance of the right passive and active left reflux.
Only the persistence of active reflux grade I right was evidenced.
