23-year-old male diagnosed with hyperrefléxic bladder secondary to myelomeningocele. He had a ventriculo-peritoneal shunt due to hydrocephalus. Despite medical treatment, the patient presented with symptoms of total urinary incontinence, with the need to use a penile collector, as well as recurrent pyelonephritis predominantly on the right side. The cystography showed the presence of a scalloped bladder with a low capacity and a right grade III passive and left grade I active vesicoureteral reflux. The cystography data were confirmed by the urodynamic study.
Laparoscopic enlargement enterocystoplasty was performed with a 15 cm detubularised ileal segment. The duration of surgery was 6 hours. Haemorrhage was about 100 cc. The postoperative period was uneventful and the patient was discharged from hospital on the ninth postoperative day.
After 18 months of follow up, the patient is in a continent state and has not had any new episodes of pyelonephritis. The cystography performed 6 months after surgery showed disappearance of the right passive and left active reflux. Only the persistence of a right grade I active reflux was evidenced.