Detrusor Hyper‐reflexia as a Factor in Spontaneous Perforation of Augmentation Cystoplasty for Neuropathic Bladder

Summary— In a series of 30 children undergoing cystoplasty for neuropathic bladder, 14 had a combination of a competent sphincteric mechanism and detrusor hyper‐reflexia. All 3 cases of spontaneous perforation of the augmentation occurred within this latter group and it is postulated that excessive intravesical pressure due to high pressure hyper‐reflexia was the causal factor. Strategies to reduce the risk of perforation are discussed.