A multitude of methods to facilitate increased bladder capacity have joined the armamentarium of urologic procedures. In children, as in adults, augmentation of the bladder with enteric segments has become very popular in the last decade. Unfortunately, many and varied complications have been delineated arising from enteric bladder augmentation. Long- and short-term morbid sequellae of enteric bladder augmentation include electrolyte abnormalities, growth and development aberrations, urinary stone disease, deterioration of the upper tracts, abnormal drug absorption, nutritional disturbances, bone disease, and malignancy.

To counter some of these maladies, it was proposed that bladder capacity could be increased by surgically excising a portion of the detrusor muscle, leaving the mucosa intact, and allowing the mucosa to expand, creating increased volume. Mahony and Laferte<sup>2 Mahony D.T., Laferte R.O. Studies of enuresis. IV. Multiple detrusor myotomy: A new operation for the rehabilitation of severe detrusor hypertrophy and hypercontractility J Urol 1972 ;  107 : 1064

Cliccare qui per andare alla sezione Riferimenti</sup> first proposed this by the creation of multiple detrusor myotomies, but the procedure did not become popular. Later, Cartwright and Snow<sup>1 Cartwright P.C., Snow B.W. Bladder autoaugmentation: Partial detrusor excision to augment the bladder without use of bowel J Urol 1989 ;  142 : 1050

Cliccare qui per andare alla sezione Riferimenti</sup> proposed excision of a portion of the detrusor and coined the term autoaugmentation. This procedure has been documented to work well as an open surgical approach. Successful use of open autoaugmentation has also been reported from Canada<sup>4 Strothers L., Johnson H., Arnold W. , e al. Bladder autoaugmentation by vesicomyotomy in the pediatric neurogenic bladder Urology 1994 ;  44 : 110

Cliccare qui per andare alla sezione Riferimenti</sup> and Germany.<sup>3 Stohrer M., Kramer A., Goepel M. , e al. Bladder auto-augmentation—an alternative for enterocystoplasty: Preliminary results Neurourol Urodyn 1995 ;  14 : 11  [cross-ref]

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The current authors thought to design a laparoscopic procedure offering a comparable approach and, hopefully, the same or better results as open autoaugmentation. Operative aim and course were carefully worked out by the two authors in consultation before undertaking the first case. Certain changes in technique have ensued with our experience.