Experimentally prefabricated bladder

Purpose: Long life expectancy after augmentation cystoplasty increases the importance of late complications of augmentation cystoplasty. Many complica tions are related to the mucosa of the intestinal flap used for augmentatio n cystoplasty. We compared a new prefabricated enterocystoplasty flap with the classic techniques of enterocystoplasty using seromuscular flaps. For p refabrication the seromuscular flap was partially grafted with uro-epitheli um before augmentation cystoplasty. Materials and Methods: The study consisted of 4 groups. In the first 2 grou ps seromuscular flaps were used for augmentation cystoplasty with different sides of the flap inside the bladder. The muscular and serosal surfaces we re prefabricated in groups 3 and 4, respectively. Prefabricated seromuscula r flaps were used for augmentation cystoplasty after remaining in situ for 2 weeks. Results: While mean augmented bladder capacity in groups 1, 2 and 4 was 18 to 20 mi. after 8 weeks, capacity in the prefabricated seromuscular enteroc ystoplasty group was 50 mi. Histopathological examination showed severe fib rosis in all except the prefabricated seromuscular enterocystoplasty group. Conclusions: Prefabrication allows the avoidance of the complications cause d by intestinal mucosa in the reservoir and results in good capacity when t he raw surface of the seromuscular flap is partially grafted with uro-epith elium before use.