What is a bladder augmentation surgery?
A bladder augmentation surgery or a cystoplasty is a procedure done to make your bladder larger using sections of your small or large intestine.
Why is it performed?
Certain conditions like spinal cord injuries, neurological conditions or any long-term conditions like multiple sclerosis can also affect your bladder in many ways including:
- Smaller size of bladder
- Bladder is unable to expand properly to hold the urine
- Sometimes a full bladder can push the urine back up the urethra (tube connecting the bladder and kidneys) which can be dangerous
Most patients have to have a special tube called a catheter placed to help with urination for a long time before considering this surgery
What happens before a surgery?
Before the surgery, your doctor will
- Review your medical history to look for any allergies, or blood-related disorders, what medicines you are using and if you have suffered a urinary tract infection in the past
- Look at the affected area either via ultrasound or via inserting a thin tube with a camera into your urethra. Also run some blood tests and x-rays
- Explain the procedure, its benefits and its risks to you
What happens during the procedure?
- You are given general anaesthesia and put to sleep
- The urologist will cut into your abdomen to access the bladder
- Make a wide opening on top of the bladder
- Cut a small section of the bladder and open up the tub-like shape of the section taken out
- Sew this onto the bladder to make it larger
- You will also have 2-3 tubes attached to allow the urine to pass normally and the bladder to heal. They also prevent any unnecessary fluid buildup
Duration of the procedure:
2-6 hours
What happens after the procedure?
- Initially fed using injections
- Will slowly be put on a liquid diet and then moved to a solid diet
- Your urine output volume will be checked regularly
- Regular checkups are needed after the procedure
- You will be taught how to take care of your catheter to prevent any blockages or other issues
- Catheter is removed around 3 weeks after the surgery
Recovery
- It is normal to feel tired in the first few days after the surgery. Get plenty of rest
- Have a high fiber diet with plenty of fluids to ensure regular bowel movement
- Mild laxatives might sometimes be required
- Your urine flow will be checked and a urine culture test will also be done before the catheter is removed
- Avoid heavy lifting in the initial few weeks until the doctor tells you its safe
- No driving for at least 6 weeks after the surgery
Benefits of bladder augmentation
A larger bladder reduces pressure on your bladder and increases the amount of time needed between going to the bathroom. The goal of this surgery is to create a bladder large enough to hold (and not leak) urine for at least four hours between catheterisations.
Risks
- Urinary tract infections
- Anaesthesia-related problems
- Healing issues
- Blood clots
- Swelling
- Bruising
- Scarring
When to contact your doctor?
- Fever of 100 F or more
- Heavy bleeding or fluid discharge from the surgical site
- Infection or pain or swelling
- Cloudy urine
- Low or no urine output
- Loss of appetite
Myths and Facts
The surgery fixes the bladder permanently, so I won't need lifelong check-ups
Bladder augmentation is considered a lifelong reconstruction. Regular follow-up is important to monitor kidney function, bladder health, metabolic changes, and potential late complications—even if you feel well
Using bowel to enlarge the bladder means the bowel tissue becomes bladder tissue.
The bowel segment continues to behave like bowel tissue. It keeps producing mucus and can absorb salts and waste products from urine, which is why regular checkups are needed
Bladder augmentation is only done to help people hold more urine
Increasing bladder capacity is only one goal. Equally important is lowering bladder pressure to help protect the kidneys from long-term damage.
References
- Cleveland Clinic. Augmentation Cystoplasty (Bladder Augmentation) [online]. Available from https://my.clevelandclinic.org/health/treatments/15846-augmentation-cystoplasty-bladder-augmentation. Accessed on 17 July 2026
- Urology Care Foundation. Bladder Augmentation (Enlargement) [online]. Available from https://www.urologyhealth.org/urology-a-z/b/bladder-augmentation-(enlargement). Accessed on 17 July 2026
- North Eastern Urology. Bladder Augmentation [online]. Available from https://northeasternurology.com.au/reconstructive-urology/bladder-augmentation/. Accessed on 17 July 2026
- National Health Services. Great Ormond Street Hospital for Children. Bladder Augmentation and Mitrofanoff [online]. Available from https://www.gosh.nhs.uk/conditions-and-treatments/procedures-and-treatments/bladder-augmentation-and-mitrofanoff/. Accessed on 17 July 2026
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