Regenerative Urinary Bladder Augmentation Using Small Intestinal Submucosa: Urodynamic and Histopathologic Assessment in Long-term Canine Bladder augmentations

Kropp, Bradley P.; Rippy, Marian K.; Badylak, Stephen F.; Adams, Mark C.; Keating, Michael A.; Rink, Richard C.; Thor, Karl B.

doi:10.1016/s0022-5347(01)66117-2

Cited by 325 publications

(210 citation statements)

References 21 publications

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“…Consequently, decellularization of biological tissues has become an attractive strategy for obtaining ECM scaffolds. A variety of acellular tissues have been used for tissue engineering, including heart valves, blood vessels, skin, tendons, ligaments, SIS, 29,46,47 UBS, and livers. 20,22 However, the decellularization of dense and compact tissues such as cartilage and meniscus remains challenging.…”

Section: Discussionmentioning

confidence: 99%

Development and Characterization of Acellular Extracellular Matrix Scaffolds from Porcine Menisci for Use in Cartilage Tissue Engineering

Chen

Jhan

et al. 2015

Tissue Engineering Part C: Methods

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Section: Discussionmentioning

confidence: 99%

Development and Characterization of Acellular Extracellular Matrix Scaffolds from Porcine Menisci for Use in Cartilage Tissue Engineering

Chen

Jhan

et al. 2015

Tissue Engineering Part C: Methods

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“…From a histopathological point of view, regeneration of bladder tissue should safely occur without evidence of graft rejection, shrinkage or systemic or bladder-related complications, such as upper tract dilatation, discontinuous urinary flow, fistula, bladder infection or calculi formation [19]. The absence of chronic cystitis in this study, which is one of the most leading causes of failure of bladder augmentation, can be explained in the light of good regeneration of the urothelium that started at the adjacent edges of the native bladder [33], subsequently rested on the basement membrane after completely covering the graft and gradually developed into a urothelium resembling a normal bladder epithelium [15].…”

Section: Discussionmentioning

confidence: 99%

Full-Thickness Hysterocystoplasty for Management of a Large Bladder Defect: Experimental Study in Goats

Abdelrhman

Seddek

Bakr

et al. 2013

The Journal of Veterinary Medical Science

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ABSTRAcT. The uterine tissue of three healthy nonpregnant goats was evaluated experimentally as a graft for closure of a bladder defect. Goats were subjected to ovariectomy, and then one detubularized uterine horn was used as a graft to close a large defect in the ventral aspect of the bladder. Follow up included monthly radiographic and ultrasonographic examinations and evaluations of kidney function and electrolytes changes for six months. The goats were euthanized after six months, and both the bladder and the graft were examined macroscopically and histologically. The technique required less invasive procedures than those described with alternative techniques of cystoplasty, achieved a high survival rate without life-threatening complications post surgery, was associated with no significant changes in kidney function and electrolytes levels, showed proper healing of the transplanted graft by regeneration rather than repair without scaring or fibrosis and with complete covering of the graft by a healthy urothelium and was associated with no malignant transformation. Hysterocystoplasty is a noninvasive, non-life-threatening technique due to the close position of the bladder to the uterus, and proper healing of the graft reflects absence of pressure on its blood supply. It is an acceptable alternative technique for closure of a large bladder defect and avoids disadvantages of alternative techniques of cystoplasty. It might be accepted by owners of pets, and further studies in clinical cases of dogs are advised. Although cystoplasty is a historic topic that has been discussed well in scientific literature and argued at legendary proportion among urologists, the search for an ideal organ to replace a diseased bladder remains elusive for reconstructive urologists [32]. Many augmentation cystoplasty or neobladder techniques have been used routinely for treatment of reduced bladder compliance and capacity secondary to bladder infection and inflammation [27], neurogenic dysfunction or congenital bladder disorders [16], detrusor over activity [10], large bladder defects [8,9], bladder necrosis [30] and bladder tumors [7,12]. Although encouraging animal and human results have been reported with different techniques, each technique had its own limitations, complications and disadvantages [2,4,11,27].The ileum and colon have been used for decades for reconstruction of the bladder, in spite of the harmful contact of urine with the mucosa of the augmenting patch [23], which is predisposed to multiple short-and/or long-term complications like chronic bacteriuria or mucous secretion [1,23], stone formation [1,11,29], disturbance of calciumphosphate metabolism with potential bone growth retardation [24,28], altered hepatic and electrolyte metabolism [24], gastrointestinal motility disorders [23], augmenting patch perforation [1,6] and malignant transformation of the augmenting patch [1,14].Gastrocystoplasty has been described as an alternative technique; unfortunately, as the popularity of gastrocystoplasty increased, so did ...

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“…The SIS proved to be able to promote regeneration of transitional epithelium of bladder and urethral smooth muscle in rabbits. 5,[28][29][30] According to Kropp,25 there is a clear difference in the response of the host tissue to the graft foreskin when compared with SIS, where the latter provided a scaffold to the regenerative and remodeling process resulting in a normal urethral epithelium. In our study, all histological parameters evaluated were similar in the different groups.…”

Section: Discussionmentioning

confidence: 99%

Comparative Study Between Porcine Small Intestinal Submucosa and Buccal Mucosa in a Partial Urethra Substitution in Rabbits

Kawano

Fugita

Yamamoto

et al. 2012

Journal of Endourology

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Purpose: Several urethral conditions may require tissue substitution. One collagen-base biomaterial that recently emerged as an option is small intestinal submucosa (SIS). The aim of this study was to compare the results of SIS and buccal mucosa for urethral substitution in rabbits. Materials and Methods: Thirty-six North Folk male rabbits were randomized into three groups. In all animals, a 10 · 5 mm urethral segment was excised, and the urethral defect was repaired using a one-layer SIS patch (group I [GI]); four-layer SIS (group II [GII]); or buccal mucosa (group III [GIII]). Urethrography was performed preoperatively and after 12 weeks. After sacrifice, graft retraction was objectively measured using Scion Image Ò computer analysis and by calculation of ellipse area. The grade of fibrosis, inflammatory reaction, vascular/ epithelial regeneration, and collagen III/I ratio were analyzed by hematoxylin/eosin and Picrosirius red staining. Results: Urethrography confirmed a wide urethral caliber without any signs of strictures after surgery. Urethral fistulae was diagnosed in 8.3% of cases (1 animal each group). Average graft shrinkage was 55.2% in GI; 44.2% in GII; and 57.2% in GIII ( p < 0.05). The intensity of chronic inflammation, fibrosis, epithelium regeneration, and neovascularization was similar in all groups ( p > 0.05). Collagen III/I ratio was higher in GII (GI: 119.6; GII: 257.2 and GIII: 115.0); p < 0.01. Conclusions: The four-layer SIS is more advantageous than the one-layer SIS and buccal mucosa for urethral substitution in rabbits.

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Regenerative Urinary Bladder Augmentation Using Small Intestinal Submucosa: Urodynamic and Histopathologic Assessment in Long-term Canine Bladder augmentations

Abstract: Small intestinal submucosa acts as a scaffold for bladder augmentation through regeneration and could be a potential option for bladder reconstruction.

Cited by 325 publications

References 21 publications

Development and Characterization of Acellular Extracellular Matrix Scaffolds from Porcine Menisci for Use in Cartilage Tissue Engineering

Development and Characterization of Acellular Extracellular Matrix Scaffolds from Porcine Menisci for Use in Cartilage Tissue Engineering

Full-Thickness Hysterocystoplasty for Management of a Large Bladder Defect: Experimental Study in Goats

Comparative Study Between Porcine Small Intestinal Submucosa and Buccal Mucosa in a Partial Urethra Substitution in Rabbits

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