Osterhage H R, Reichert H E, Bülow H, Wünsch H P
Urol Int. 1983;38(2):74-7. doi: 10.1159/000280867.
Smooth muscle transplants of the intestinal tract have been tested experimentally as a substitute for the bladder sphincter. An attempt was made to apply the proposed technique to the vesical muscle tissue and to achieve a sphincter replacement with freely transplanted autologous bladder tissue. An internal urethrotomy was performed several times in female sheep until a complete urinary incontinence resulted. For the bladder sphincter substitute a strip of vesical tissue was dissected from the anterior wall and following pre-stretching it was sewed circumferentially around the urethra in order to constrict it. The urethral pressure was registered during the operation before and after application of the sphincter 'graft'. For temporary urinary discharge a suprapubic catheter was inserted. The sheep were examined clinically and urodynamically for up to 3 months. Complete urinary continence was not obtained in any of the cases. The urodynamic examination showed a nearly complete loss of the urethral pressure which had been obtained by the operation. The histological studies showed progressing fibrosis of the desired continence zone. By way of freely transplanted autologous vesical muscle a sphincter substitute could not be achieved.
肠道平滑肌移植已作为膀胱括约肌的替代品进行了实验测试。人们试图将所提出的技术应用于膀胱肌肉组织，并通过自由移植自体膀胱组织来实现括约肌替代。对雌性绵羊多次进行内尿道切开术，直至出现完全尿失禁。对于膀胱括约肌替代物，从前壁切下一条膀胱组织条，在预拉伸后将其围绕尿道进行圆周缝合以使其收缩。在应用括约肌“移植物”之前和之后的手术过程中记录尿道压力。为了临时排尿，插入耻骨上导管。对绵羊进行了长达3个月的临床和尿动力学检查。所有病例均未实现完全尿失禁。尿动力学检查显示手术获得的尿道压力几乎完全丧失。组织学研究显示预期的控尿区域出现进行性纤维化。通过自由移植自体膀胱肌肉无法实现括约肌替代。
