BLADDER AUGMENTATION USING ALLOGENIC BLADDER SUBMUCOSA SEEDED WITH CELLS

Objectives. The search for a suitable material to reconstruct the geni tourinary tract has been a challenging task. Bower has been widely use d for urinary tract reconstruction, despite its subsequent complicatio ns. We investigated the possibility of using allogenic bladder submuco sa, a tissue consisting of nonimmunogenic acellular collagen, either w ith or without cells, as a material for bladder augmentation. Methods. Partial cystectomies were performed in 10 beagle dogs. Both urothelia l and smooth muscle cells were harvested and expanded separately in 5 animals. The allogenic bladder submucosa obtained from sacrificed dogs was seeded with muscle cells on one side and urothelial cells on the opposite side. All beagles underwent cruciate cystotomies on the bladd er dome. Augmentation cystoplasty was performed with the allogenic bla dder submucosa seeded with cells in 5 animals and with the allogenic b ladder submucosa without cells in 5. The augmented bladders were retri eved 2 and 3 months after augmentation. Results. Bladders augmented wi th the allogenic bladder submucosa seeded with cells showed a 99% incr ease in capacity compared with bladders augmented with the cell-free a llogenic bladder submucosa, which showed only a 30% increase in capaci ty. All dogs showed a normal bladder compliance, as evidenced by urody namic studies. Histologically, all retrieved bladders contained a norm al cellular organization consisting of a urothelial lined lumen surrou nded by submucosal tissue and smooth muscle. Immunocytochemical analys es confirmed the urothelial and muscle cell phenotype and showed the p resence of nerve fibers. Conclusions. These results show that allogeni c bladder submucosa seeded with cells appears to be an excellent optio n as a biomaterial for bladder augmentation. (C) 1998, Elsevier Scienc e Inc. All rights reserved.