Laparoscopic augmentation cystoplasty: a comparison between native ileum and small intestinal submucosa in the porcine model

Wang, David S.; Anderson, David; Fretz, Peter C.; Nguyen, Thai T.; Winfield, Howard N.

doi:10.1111/j.1464-410x.2006.06662.x

Cited by 11 publications

(9 citation statements)

References 18 publications

(23 reference statements)

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“…This temporal mismatch shifts in favour of the degradation rate and greatly contributes to postoperative complications such as poor compliance, decreased bladder capacity and significantly impaired renal function. Complications of this nature may persist unabated until the remodelling response has been completed after 90–120 days [7], [19]. Preliminary studies in our laboratory have demonstrated that an increase in ECM surface-area relative to its intended bladder defect may prevent these complications by increasing the storage reservoir of the bladder [9].…”

Section: Discussionmentioning

confidence: 99%

“…A paucity of literature is available on AC with ECMs, however one recent study by Wang et al . assessed AC with autogenous ileum and small intestinal submucosa (SIS) in a porcine model [19]. Findings from their study demonstrated greater capacity increases in bladder's augmented with ileum (211 ml) compared to SIS (144.3 ml) after a 6 week experimental time period.…”

Section: Discussionmentioning

confidence: 99%

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Augmentation Cystoplasty and Extracellular Matrix Scaffolds: An Ex Vivo Comparative Study with Autogenous Detubularised Ileum

et al. 2011

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BackgroundAugmentation cystoplasty (AC) with autogenous ileum remains the current gold standard surgical treatment for many patients with end-stage bladder disease. However, the presence of mucus-secreting epithelium within the bladder is associated with debilitating long-term complications. Currently, decellularised biological materials derived from porcine extracellular matrix (ECM) are under investigation as potential augmentation scaffolds. Important biomechanical limitations of ECMs are decreased bladder capacity and poor compliance after implantation.Methodology/Principal FindingsIn the present ex vivo study a novel concept was investigated where a two-fold increase in ECM scaffold surface-area relative to the resected ileal segment was compared in ovine bladder models after AC. Results showed that bladder capacity increased by 40±4% and 37±11% at 10 mmHg and compliance by 40.4±4% and 39.7±6% (ΔP = 0–10 mmHg) after AC with ileum and porcine urinary bladder matrix (UBM) respectively (p<0.05). Comparative assessment between ileum and UBM demonstrated no significant differences in bladder capacity or compliance increases after AC (p>0.05).ConclusionsThese findings may have important clinical implications as metabolic, infective and malignant complications precipitated by mucus-secreting epithelium are potentially avoided after augmentation with ECM scaffolds.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Augmentation Cystoplasty and Extracellular Matrix Scaffolds: An Ex Vivo Comparative Study with Autogenous Detubularised Ileum

et al. 2011

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“…Many authors described the appearance of adhesions during the macroscopic post-mortem examination [13,20]. In this work only few mild cases of adhesions were found, mostly to the omentum and rectum.…”

Section: Discussionmentioning

confidence: 92%

Histerocystoplasty: A Novel Surgical Procedure in the Rat

Dapena

Regadera

et al. 2012

Journal of Surgical Research

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“…Bladder reconstruction with SIS has demonstrated regeneration of transitional epithelium, smooth muscle and nerves in various different animal models. [5859] Although the initial results have been promising, long-term results have been poor. This is due to the complications such as fibrosis resulting in graft shrinkage, graft incrustation or infection.…”

Section: Alternative Optionsmentioning

confidence: 99%

Bladder augmentation: Review of the literature and recent advances

et al. 2007

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Bladder augmentation is an important tool in the management of children requiring reconstructions for urinary incontinence or preserving of the upper urinary tract in congenital malformations. We reviewed the literature and evaluated the long-term results of enterocystoplasty in the pediatric age group and summarized techniques, experimental options and future perspectives for the treatment of these patients. For this purpose, a directed Medline literature review for the assessment of enterocystoplasty was performed. Information gained from these data was reviewed and new perspectives were summarized. The ideal gastrointestinal (GI) segment for enterocystoplasty remains controversial. The use of GI segments for enterocystoplasty is associated with different short and long-term complications. The results of different centers reported in the literature concerning urological complications after enterocystoplasty are difficult to compare because of the non-comparable aspects and different items included by different authors. On the other hand, there are more and more case reports about cancer arising from bowel segments used for bladder augmentation in recent publications.Although bladder reconstruction with GI segments can be associated with multiple complications, such as metabolic disorders, calculus formation, mucus production, enteric fistulas and potential for malignancy, enterocystoplasty is unfortunately still the gold standard. However, there is an urgent need for the development of alternative tissues for bladder augmentation.

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Laparoscopic augmentation cystoplasty: a comparison between native ileum and small intestinal submucosa in the porcine model

Cited by 11 publications

References 18 publications

Augmentation Cystoplasty and Extracellular Matrix Scaffolds: An Ex Vivo Comparative Study with Autogenous Detubularised Ileum

Augmentation Cystoplasty and Extracellular Matrix Scaffolds: An Ex Vivo Comparative Study with Autogenous Detubularised Ileum

Histerocystoplasty: A Novel Surgical Procedure in the Rat

Bladder augmentation: Review of the literature and recent advances

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