Bladder autoaugmentation in the rabbit using de-epithelialized segments of small intestine, stomach and lyophilized human dura mater.

OBJECTIVE

To develop an animal model of partial detrusorectomy (autoaugmentation) and thus avoid the consequences of the direct contact of intestinal mucosa with the urinary tract in bladder augmentation.

MATERIALS AND METHODS

A diverticular urothelial bulge was created and patched with demucosalized segments of small bowel (group A), stomach (group B) and with lyophilized human dura mater (group C). The surgery was performed on 50 New Zealand rabbits which were compared with 10 control animals and killed at 2, 4 and 6 weeks after surgery. Urodynamic studies and cystography were performed before operation and at death, and the augmented bladders examined histologically.

RESULTS

Six weeks after the procedure, the mean (SD) bladder compliance was 22.7 (5.7) in group A (intestinal patch. n = 6). 2.3 (0.5) in group B (stomach patch, n = 3). 3.1 (1.9) in group C (lyophilized human dura, n = 3) and 9.4 (0.4) in the control group (n = 4). Histological studies showed residual enteric and gastric mucosa but an intact urothelium under the intestinal patch.

CONCLUSION

The results of this experimental study suggest that a demucosalized segment of small bowel is the best material to increase bladder compliance in detrusorectomy (autoaugmentation) as applied in this animal model.