An original technique for bladder autoaugmentation with protective abdominal rectus muscle flaps: an experimental study in rats
| Autor: | C. Pintus, Perrelli L, Carlo Manzoni, Carmine D'Urzo, A. Grottesi, Guido Fadda |
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| Rok vydání: | 2001 |
| Předmět: |
medicine.medical_specialty
media_common.quotation_subject Urinary Bladder Urinary Diversion Urination Surgical Flaps Cystography medicine Animals Rats Wistar Rectus abdominis muscle media_common Abdominal Muscles Urinary bladder medicine.diagnostic_test business.industry Urinary retention Bladder Exstrophy medicine.disease Surgery Rats Bladder exstrophy medicine.anatomical_structure Bladder augmentation Models Animal Bladder stones medicine.symptom business |
| Zdroj: | The Journal of surgical research. 99(2) |
| ISSN: | 0022-4804 |
| Popis: | Background. Bladder autoaugmentation uses partial detrusorectomy to create a diverticular bulge in the bladder mucosa. This technique has eliminated certain serious complications of cystoplasty with gastrointestinal tissues (e.g., fluid/electrolyte/acid-base imbalances, mucous hypersecretion), but the exposed mucosa is subject to fibrosis and, sometimes, to perforation, which can annul the benefits of surgery. Methods. We have developed an original technique based on traditional autoaugmentation with protection of the herniated mucosa by split-thickness pedunculated rectus abdominis muscle flaps that are sutured to the incised margins of the detrusor. Preliminary testing was done on 30 adult Wistar rats. A control group of 15 rats underwent laparotomy alone. Bladder capacity was measured via suprapubic cystography before and after (4 weeks, 8 weeks, 1 year) surgery, just before sacrifice. Sections of the reconstructed bladder were examined histologically. Results. Twenty-three bladder-augmented rats and 13 controls survived. In the experimental group, bladder capacity increased by 38% (mean). None of the rats experienced urinary retention, although one developed bladder stones. Histology revealed no pathologic changes (other than chronic inflammatory infiltrates at suture sites) in the mucosa, detrusor, or muscle flaps, which were all viable and well integrated by the fourth postoperative week. There were no signs of mucosal or muscle fibrosis. Conclusions. Preliminary results in a rat model suggest that this new technique can produce an enlarged bladder that is fully functional and less vulnerable to fibrotic retraction and rupture. Residual contractility in the muscle flaps might theoretically be exploited to facilitate paraphysiologic micturition. |
| Databáze: | OpenAIRE |
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