RECTUS-ABDOMINIS MUSCLE FLAP (RAMF) TECHNIQUE FOR THE MANAGEMENT OF LARGE BLADDER DEFECTS - URODYNAMIC FINDINGS IN A RABBIT MODEL

Objective To investigate the efficacy of the rectus abdominis muscle f lap (RAMF) technique for the closure and augmentation of small, inelas tic bladder extrophies using a rabbit model with a large bladder defec t. Materials and methods Fifteen New Zealand White rabbits were studie d in two groups; nine rabbits in group 1 underwent resection of 65% of the bladder and then bladder augmentation using a full-thickness RAMF , including peritoneum, and six rabbits in group 2 (control) underwent a similar bladder resection but. the bladder remnant was closed prima rily. Urodynamic investigations were carried out in both groups preope ratively and 4 weeks after surgery. Intravenous pyelography (IVP), voi ding cystourethrography (VCUG), urodynamic and histopathological inves tigations were also carried out for up to 4 months after surgery. Resu lts As assessed by IVP, the urinary system appeared normal, with no si gns of upper urinary tract dilatation and VCUG showed a normal voiding pattern. After surgery, the bladder capacity and compliance decreased in both groups, but both variables partially recovered in group 1, al though not significantly. Conclusions This animal model indicates that the RAMF technique is a suitable alternative for the management of la rge bladder defects and bladder exstrophies with small, inelastic, non -compliant bladders.