Bh. Bochner et al., A SEROUS LINED ANTIREFLUX VALVE - IN-VIVO FLUOROURODYNAMIC EVALUATIONOF ANTIREFLUX CONTINENCE MECHANISM, The Journal of urology, 160(1), 1998, pp. 112-115
We evaluate the fluoroscopic and urodynamic performance of a new seros
al lined antireflux continence valve (T pouch valve) using an in vivo
animal model. Materials and Methods: Intestinal reservoirs were constr
ucted using an in vivo pig model. Multiple serosal lined valves of var
ying diameters and tunnel lengths were evaluated in the acute (immedia
tely after construction) and chronic (4 weeks postoperatively) setting
s. Video fluorourodynamic evaluations were performed to identify valve
leak point pressures and optimal tunnel length-to-luminal diameter ra
tios. Results: Four serosal lined valves tapered to a diameter of 18 a
nd 30F in 1 and 2 cm. tunnels were evaluated. Immediately following co
nstruction of the valves no leakage was observed during reservoir fill
ing (maximal pressure 50 cm. water) or external compression maneuvers
to simulate a Valsalva maneuver (maximal intra-reservoir pressure 100
cm. water). Identical fluorourodynamic studies performed after a 4-wee
k recuperation demonstrated leakage through the 30F, 1 cm, tunnel valv
e during reservoir filling (intra-reservoir pressure 19 cm. water). In
creasing the tunnel length of the 30F system to 2 cm. (tunnel length-t
o-luminal diameter ratio 2:1) eliminated all evidence of valve leakage
up to a maximal intra-reservoir pressure of 100 cm. water. Conclusion
s: These studies demonstrate the urodynamic characteristics of a new s
erosal lined valve. This easily constructed mechanism serves as a reli
able antireflux (afferent) or continence (efferent) system.