Reconstructive urology · London
Cystoplasty — bladder augmentation, honestly explained.
A specialist reconstructive operation to enlarge a small, high-pressure or refractory bladder using a segment of bowel — with or without a Mitrofanoff channel. A serious step, only after everything else has been tried.
Why patients choose us
- 01
A functional urology and reconstructive surgeon
Cystoplasty is a specialist reconstructive operation. Your case is led by a consultant who does bladder reconstruction as a regular part of their practice — not an occasional add-on.
- 02
The full non-surgical ladder first
Anticholinergics, beta-3 agonists, intradetrusor botulinum toxin and intermittent self-catheterisation are all considered before augmentation is offered.
- 03
Life-long follow-up planned from day one
An augmented bladder needs annual review, metabolic checks and cystoscopic surveillance. We map that pathway before you consent to surgery.
Indicative pathway costs
What a private cystoplasty pathway costs in London.
Indicative ranges across our reconstructive urology network. Most cases are insurer-funded when medically indicated — we confirm cover and firm figures before booking.
In short
Ileocystoplasty in our network: £18,000–£32,000 self-pay, typically insurer-funded when medically indicated.
| Step | Indicative range | Typical duration | Recovery / turnaround |
|---|---|---|---|
| Consultation with reconstructive urologist | £300–£500 | 45–60 min | Same visit |
| Urodynamic studies (pre-op) | £850–£1,400 | 60–90 min | 1 week |
| Flexible cystoscopy (pre-op) | £700–£1,200 | 20–30 min LA | Same visit |
| Ileocystoplasty (bladder augmentation) | £18,000–£32,000 | 4–6 hr GA | 7–10 day stay |
| Ileocystoplasty with Mitrofanoff channel | £24,000–£40,000 | 5–7 hr GA | 10–14 day stay |
| Annual surveillance cystoscopy (long-term) | £700–£1,200 | 20–30 min | Same visit |
Prices vary by hospital, by consultant, by whether a Mitrofanoff channel is added, and by length of stay. Life-long surveillance is a separate ongoing cost — we set that out before you decide.
The problem
The right surgeon, the right indication, the right long-term plan.
Cystoplasty is offered too early in some clinics and too late in others. It should be reserved for the patient whose bladder genuinely cannot be salvaged with medication, botulinum toxin or neuromodulation — and it should never be booked without a life-long follow-up pathway attached.
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Not sure it is needed?
Sacral neuromodulation, repeat botulinum toxin cycles and optimised CISC may still avoid surgery. We say so before you consent.
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Worried about CISC?
Most patients will catheterise for life after augmentation. A specialist nurse teaches it — and a Mitrofanoff is an option if the urethra is not.
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Want it done properly?
A named reconstructive urologist, a tertiary theatre, a stoma nurse and a life-long surveillance schedule — not a one-off booking.
The journey
From workup to life-long follow-up — what happens, in order.
One reconstructive team from first workup to every year afterwards.
Phase 1 · Workup and decision
Weeks to months, off-stage
Phase 2 · Surgery and inpatient
7–14 days in hospital
Phase 3 · CISC and life-long
Ongoing, forever
- 01
Workup
Workup and diagnosis
Urodynamic studies, cystoscopy, renal tract imaging and blood tests confirm a small-capacity, high-pressure or refractory neurogenic bladder and rule out reversible causes.
- 02
Workup
Non-surgical options exhausted
Anticholinergics, beta-3 agonists, intradetrusor botulinum toxin and clean intermittent self-catheterisation (CISC) are trialled and documented.
- 03
Workup
Shared decision
A detailed consultation covers augmentation with or without a Mitrofanoff, the commitment to life-long CISC, metabolic risk and cancer surveillance.
- 04
Surgery
Surgery in a tertiary theatre
Open ileocystoplasty under general anaesthetic — a detubularised segment of ileum is anastomosed to the bisected bladder, with a Mitrofanoff channel formed if agreed.
- 05
Surgery
Inpatient recovery
Seven to ten days in hospital with a urethral catheter, suprapubic catheter and pelvic drain. Bowel function returns before discharge.
- 06
After
CISC training and cystogram
A cystogram at around three weeks confirms healing; catheters come out and CISC training with a specialist nurse begins.
- 07
After
Life-long follow-up
Annual review, renal function and vitamin B12 checks, and cystoscopic surveillance from ten years post-op for the recognised long-term cancer risk.
Typical workup-to-surgery: 2–3 months. Full functional recovery: 2–3 months. Surveillance: life-long.
When it helps
When cystoplasty is the right step.
The indications we see most, plus the red flag that means an emergency rather than a clinic appointment.
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Neurogenic bladder
Spinal cord injury, spina bifida or multiple sclerosis causing a small-capacity, high-pressure bladder that threatens the kidneys.
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Refractory overactive bladder
Severe, incapacitating overactive bladder that has failed anticholinergics, beta-3 agonists and repeated intradetrusor botulinum toxin.
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Contracted, small-capacity bladder
A fibrosed, low-compliance bladder after tuberculosis, pelvic radiotherapy or chronic inflammation, causing intractable frequency and upper-tract damage.
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Interstitial cystitis / bladder pain
A rare last resort in end-stage bladder pain syndrome after every conservative and intravesical option has been exhausted.
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Failed CISC via the urethra
A patient who cannot catheterise the urethra — through disability, urethral disease or preference — may be offered a Mitrofanoff channel at the same operation.
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Upper-tract deterioration
Falling glomerular filtration rate, new hydronephrosis or high-pressure reflux from a hostile bladder are strong indications to reconstruct.
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Detrusor overactivity in spina bifida
Young adults with spina bifida whose bladders no longer accommodate safe volumes despite maximal medical therapy.
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Red flag: rupture of augmented bladder
Sudden severe abdominal pain, distension or shock in a previously augmented bladder is a surgical emergency — call 999, not the clinic.
Technique options
Ileocystoplasty is the default — but not the only option.
What each technique on the table actually involves — and which fits which patient.
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Ileocystoplasty
The standard operation. A detubularised segment of terminal ileum is opened along its length and sewn onto the bisected bladder to enlarge capacity and lower pressures.
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Ileocystoplasty with Mitrofanoff
An appendicovesicostomy (or a Monti tube if the appendix is unavailable) is brought to the skin as a continent catheterisable channel for CISC.
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Colocystoplasty
A segment of sigmoid colon is used instead of ileum. Now uncommon — reserved for cases where ileum is unavailable or unsuitable.
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Gastrocystoplasty
A segment of stomach is used. Largely of historical interest because of the haematuria–dysuria syndrome and metabolic issues.
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Ureterocystoplasty
A dilated non-functioning ureter is used as the augmentation tissue — an option in selected paediatric and reconstructive cases.
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Autoaugmentation (detrusor myectomy)
The detrusor muscle is stripped from a portion of the bladder dome to create a pseudo-diverticulum. No bowel is used, but results are variable.
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Substitution cystoplasty
The bladder is largely replaced rather than augmented. Considered when almost no functional bladder remains.
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Non-surgical alternatives revisited
Sacral neuromodulation, repeat botulinum toxin cycles and optimised CISC may still avoid surgery for the right patient.
Our vetted London network
A small panel of reconstructive urologists, we picked them.
Consultant functional and reconstructive urologists at London tertiary centres. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every reconstructive urologist in our network.
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Consultant reconstructive and functional urologists — not general urology lists
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Access to formal urodynamic studies and video-urodynamics
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Specialist continence and stoma nurses for CISC and Mitrofanoff training
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Life-long surveillance pathway with renal, metabolic and cystoscopic follow-up
Risks and long-term care
The complications you need to know about — honestly.
An augmented bladder behaves differently from a native one. Most complications are manageable if you know what to look for and stay in surveillance.
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Mucus plugging
Bowel mucosa continues to secrete mucus inside the bladder. Regular bladder washouts and generous fluid intake keep the catheter clear.
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Urinary tract infection and pyelonephritis
Colonisation is the rule; symptomatic infection is treated. Recurrent pyelonephritis needs urgent review — it can damage the kidneys.
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Stones in the augmented bladder
Mucus and residual urine favour stone formation. Cystoscopy will find them; most can be broken up and removed endoscopically.
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Hyperchloraemic metabolic acidosis
Bowel reabsorbs chloride and ammonium from urine. Blood gases and bicarbonate are checked; oral bicarbonate is sometimes needed long term.
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Vitamin B12 deficiency
The terminal ileum absorbs B12. Levels are checked annually from about five years post-op and replaced if low.
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Bowel obstruction and adhesions
A recognised late complication of any open abdominal surgery. Persistent vomiting or absolute constipation needs urgent assessment.
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Stomal complications (if Mitrofanoff)
Stenosis, false passage, prolapse or leakage of the catheterisable channel — most are managed with dilatation or minor revision.
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Spontaneous rupture
Rare but serious. Related to over-distension or infection. Any sudden severe abdominal pain in an augmented bladder is a surgical emergency.
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Cancer in the augmented bladder
A recognised long-term risk — small, but real. Annual cystoscopic surveillance is offered from about ten years post-operation.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever technique was used, the note the reconstructive urologist sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication and technique
Why the operation was done — neurogenic bladder, refractory overactive bladder, contracted bladder — and which technique was used (ileocystoplasty with or without Mitrofanoff).
- 02 Technique
Bowel segment and reconstruction
Which segment of ileum was used, how it was detubularised, how the anastomosis to the bladder was fashioned and how the Mitrofanoff was sited.
- 03 Findings
Intra-operative findings and drains
Bladder capacity and appearance, the state of the ureters, and which catheters and drains have been left in and for how long.
- 04 Impression
Follow-up plan and surveillance
Read this first: the CISC regime, cystogram timing, when the catheters come out, and the long-term metabolic and cancer-surveillance schedule.
Recognised by major UK insurers
Cystoplasty is usually insurer-funded when medically indicated, subject to pre-authorisation and evidence of failed conservative treatment. We confirm cover before booking.
Frequently asked
Everything we get asked about cystoplasty.
Straight answers on indications, catheterisation, hospital stay, and life-long follow-up.
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What is a cystoplasty?
A reconstructive urological operation that enlarges the bladder using a segment of bowel — most commonly ileum, giving an ileocystoplasty. It lowers bladder pressures, increases capacity and protects the kidneys in people whose bladder can no longer do those jobs safely.
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Who needs a cystoplasty?
It is offered mainly for neurogenic bladder (spinal cord injury, spina bifida, multiple sclerosis), refractory overactive bladder that has failed anticholinergics and botulinum toxin, and small-capacity contracted bladders after tuberculosis or radiotherapy. Interstitial cystitis is a rare last-resort indication.
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Will I still be able to pass urine normally afterwards?
Usually not. Most people who have an augmentation cystoplasty need to empty the bladder by clean intermittent self-catheterisation (CISC) for the rest of their life. This is discussed in detail before you consent.
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What is a Mitrofanoff channel?
A continent catheterisable channel — usually made from the appendix — brought to the skin (often at the umbilicus). It lets you catheterise into the bladder without using the urethra, which matters if the urethra is difficult, painful or inaccessible.
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How long is the hospital stay and recovery?
Expect seven to ten days in hospital, sometimes longer if a Mitrofanoff is added. You will go home with catheters that stay in for around three weeks. Full recovery to normal activity takes two to three months; heavy lifting is avoided for six weeks.
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What are the main long-term risks?
Mucus in the urine, urinary tract infections, bladder stones, hyperchloraemic acidosis, vitamin B12 deficiency, bowel adhesions, stomal problems with a Mitrofanoff, rare rupture of an over-distended augmented bladder, and a small but recognised long-term risk of cancer in the augmented bladder.
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Why do I need life-long follow-up?
Because the metabolic effects, stone risk and cancer risk all persist for life. Expect annual review, blood tests for renal function, bicarbonate and B12, and cystoscopic surveillance from around ten years post-operation.
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What should send me straight to A&E after a cystoplasty?
Sudden severe abdominal pain or distension (possible rupture), a high fever with loin pain (pyelonephritis), inability to catheterise or drain the bladder, or heavy visible blood in the urine. Any of these warrant same-day assessment.
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Are there alternatives to cystoplasty?
Yes — and they should all be tried first. Anticholinergics, beta-3 agonists, repeated intradetrusor botulinum toxin, sacral neuromodulation and optimised CISC can control many bladders without surgery. Augmentation is a step reserved for patients who have exhausted these options.
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Is cystoplasty covered by private medical insurance?
Usually yes, when the operation is medically indicated (neurogenic bladder, refractory overactive bladder, upper-tract damage). Pre-authorisation and evidence of failed conservative treatment are almost always required. We confirm cover before booking.
Related tests
Looking for something else?
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Cystoscopy
The direct look inside the bladder — for diagnosis and surveillance.
Learn more -
Urodynamic studies
Measures bladder pressure, capacity and compliance before reconstruction.
Learn more -
Urine flow test
The simple first-line test of how well the bladder empties.
Learn more -
All tests
Every test and procedure we arrange.
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Hypertension
Related condition guide.
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Type 2 Diabetes
Related condition guide.
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Blood Tests
Related diagnostic test.
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Health Assessments Select
Related diagnostic test.
Learn more
In practice, in London
Getting cystoplasty sorted in London, without the guesswork
For cystoplasty, the private London route is mostly about consultant fit and hospital choice rather than raw waiting time. Waiting lists on the NHS for cystoplasty vary widely by borough and by how the GP letter reads. Privately in London, we can normally offer a slot inside the same week, sometimes within 48 hours if there’s a cancellation. The difference isn’t clinical quality — the consultants are frequently the same faces you’d see on the NHS — it’s the calendar.
A private cystoplasty pathway in London usually looks like this: an initial consultation, any diagnostics booked at a nearby facility (most within Zone 1 or 2), and a written report sent to you and your GP within a few days. The consultants we work with hold NHS posts alongside their private lists, which keeps the standards consistent across both settings. For cystoplasty in particular, we bias towards consultants who do this every week rather than every month.
Where a good concierge earns its keep is in the matching. There are dozens of consultants in London who see cystoplasty — but not all of them are the right fit for every case. We narrow it down based on subspecialty, insurer coverage, the specific question being asked, and whether continuity into treatment matters. The right first appointment saves you from repeating yourself later.