Cayan Selahitten, Chermansky Christopher, Schlote Norbert, Sekido Noritoshi, Nunes Lora, Dahiya Rajvir, Tanagho Emil A
Department of Urology, University of California San Francisco, School of Medicine, San Francisco, California, USA.
J Urol. 2002 Aug;168(2):798-804. doi: 10.1016/s0022-5347(05)64746-5.
We investigated the feasibility of augmentation in a diseased bladder with a bladder acellular matrix graft.
In 50 female Sprague-Dawley rats chemical cystitis was induced by intravesical instillation of HCl repeated monthly to maintain chronic inflammation. Urodynamic studies were performed in all rats 1 week after the induction of chemical cystitis and repeated at sacrifice. The 29 rats in the experimental group underwent partial cystectomy (50% or greater), followed by bladder acellular matrix graft augmentation, while the 21 controls underwent monthly HCl instillation only. The rats were sacrificed at 2 weeks, 1, 2 and 3 months, respectively. The bladder was removed and examined for histological changes.
Urodynamic studies showed that bladder capacity and compliance were significantly higher in the grafted than in the control group (p = 0.008 and 0.006, respectively, at 3 months). Histological studies revealed urothelial and smooth muscle regeneration within the bladder acellular matrix graft at 1 month and nerve regeneration at 3. The number of mast cells was significantly lower in the grafted region than in the host bladder of all grafted rats (p <0.001).
In this rat chemical cystitis model bladder augmentation with a bladder acellular matrix graft led to functional and histological improvement over diseased host bladder.
我们研究了使用膀胱脱细胞基质移植物对患病膀胱进行扩大术的可行性。
在50只雌性斯普拉格-道利大鼠中,通过每月膀胱内灌注盐酸诱导化学性膀胱炎以维持慢性炎症。在诱导化学性膀胱炎1周后对所有大鼠进行尿动力学研究,并在处死时重复进行。实验组的29只大鼠接受了部分膀胱切除术(50%或更多),随后进行膀胱脱细胞基质移植物扩大术,而21只对照组大鼠仅每月接受盐酸灌注。大鼠分别在2周、1个月、2个月和3个月时处死。取出膀胱并检查组织学变化。
尿动力学研究表明,移植组的膀胱容量和顺应性在3个月时显著高于对照组(分别为p = 0.008和0.006)。组织学研究显示,膀胱脱细胞基质移植物内1个月时出现尿路上皮和平滑肌再生,3个月时出现神经再生。所有移植大鼠移植区域内肥大细胞的数量显著低于宿主膀胱(p <0.001)。
在这个大鼠化学性膀胱炎模型中,使用膀胱脱细胞基质移植物进行膀胱扩大术相较于患病的宿主膀胱在功能和组织学方面有改善。