BLADDER AUTOAUGMENTATION IN THE RABBIT USING DEEPITHELIALIZED SEGMENTS OF SMALL-INTESTINE, STOMACH AND LYOPHILIZED HUMAN DURA-MATER

Objective To develop an animal model of partial detrusorectomy (autoau gmentation) and thus avoid the consequences of the direct contact of i ntestinal mucosa with the urinary tract in bladder augmentation. Mater ials and methods A diverticular urothelial bulge was created and patch ed with demucosalized segments of small bowel (group A), stomach (grou p B) and with lyophilized human dura mater (group C), The surgery was performed on 50 New Zealand rabbits which were compared with 10 contro l animals and killed at 2, 4 and 6 weeks after surgery. Urodynamic stu dies and cystography were performed before operation and at death, and the augmented bladders examined histologically. Results Six weeks aft er tile 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 resid ual enteric and gastric mucosa but an intact urothelium under the inte stinal patch. Conclusion The results of this experimental study sugges t that a demucosalized segment of small bowel is the best material to increase bladder compliance in detrusorectomy (autoaugmentation) as ap plied in this animal model.