ALLOPLASTIC REPLACEMENT OF THE URINARY-BLADDER

Purpose: The loss of a functioning bladder is nowadays mostly managed by replacement with gastrointestinal segments. Management of these uri nary diversions is difficult and the long-term effects are unknown. We developed a silicone rubber prosthesis for alloplastic replacement of the urinary bladder and tested it in an animal experiment. Material a nd Methods: Two artificial bladders were implanted into subcutaneous p ockets on each side of the anterior abdominal wall. Cystectomy was per formed and each prosthesis was connected to one kidney, Distally, a Y- shaped tube sutured to the urethral stump joined the two bladder outle ts, The whole system was successfully implanted in 5 sheep with a mean follow-up of 11.5 months (5-19 months). Results: Adequate capacity, e ffective and reliable mechanical function and patent anastomoses to th e renal pelvis and the urethra could be achieved. Blood chemistry and renal ultrasound were performed at regular intervals demonstrating nei ther morphological nor functional deterioration of the renal parenchym a. Histopathological examination in the end of the experiment confirme d the excellent clinical results. Conclusions: The positive outcome of these animal experiments suggests this system would be useful for hum an bladder substitution. Standardized industrial production of the pro stheses will be needed prior to implantation in humans.