Ureteric tunnel incision in the fetal pig: a model for non-obstructive prenatal vesicoureteric reflux

Abstract

The understanding of vesicoureteric reflux (VUR) continues to improve, particularly as the renal tract can now be assessed prenatally. To further study the evolution of fetal renal changes, we studied two neonatal piglets that had undergone midgestation ureteric tunnel ablation. Dilatation of the pelvicalyceal system was seen radiologically and macroscopically in all three kidneys into which VUR had been created. Despite the study being marred by poor fetal survival, the results indicate that the model should be developed further to explore what appears to be an interrelationship between VUR and renal parenchymal changes in utero.

Comparing Aachen Minipigs and Pietrain Piglets as Models of Experimental Pediatric Urology to Human Reference Data

“…Considering renal surgery, the smaller organs in both pig breeds compared to humans should not preclude experimental approaches, it is rather the other way round: if surgical procedures work out in the smaller and thus more difficult swine models, their translation into humans should be facilitated for larger organs. As swine have been proven to be a useful model of even fetal urologic surgery [8] and have voiding patterns similar to humans [25], our results of anatomic similarity in ureteral length corroborate the previous assumption that they would be suitable models of experimental pediatric urology. This is true for both minipig and landrace breeds for the age of 3 weeks and 3 months, respectively.…”

“…Swine have been important models for the introduction of innovative techniques in endoscopic [3], robotic [7], and fetal [8] urology. Analogous to esophageal surgery, minipig breeds were introduced [10] in experimental pediatric urology, too.…”

“…Consequently, the endoscopic subureteral Teflon injection has been developed in piglets [3] and has been translated successfully into everyday clinical practice [4]. Following these pioneering works, landrace piglets were the porcine model of choice in experimental pediatric urology -similar to pediatric esophageal surgery [5] -for endourologic investigations [6], robotic [7], and fetal surgery [8]. Although the Göttingen Minipig as the archetype of a minipig has been bred at the beginning of the 1960s [9], it was not until 1993 that minipigs first appeared as a model in experimental pediatric urology with a laparoscopic Lich-Gregoir procedure in Hanford Minipigs [10].…”