Prevention of colonic mucosal regrowth after seromuscular enterocystoplasty

Purpose: To find answers about preventing the colonic mucosal regrowth afte r seromuscular enterocystoplasty and the dissection pane, we performed an e xperimental study in dogs. We also report our experience with mucosal regro wth and bladder function after augmentation colocystoplasty. Materials and Methods: This study comprised 10 adult healthy female mongrel dogs. We performed this animal experiment in 2 stages. At stage 1 we const ructed a low capacity bladder. Stage 2 was performed 6 months after stage 1 . At the end of detrusorectomy a 15 cm. segment of sigmoid colon was detubu larized. The animals were randomly divided into 2 groups. In the 5 group 1 dogs de-epithelialization was performed with needle point cautery at a low cut setting, and the mucosa, muscularis mucosa and submucosa were resected, leaving the fibers of the muscularis externa exposed. In the 5 group 2 dog s de-epithelialization was performed by the peeling technique, in which the dissection plane was developed between the mucosa and muscularis mucosa, a nd the muscularis mucosa and submucosa remained on the colonic muscle. The de-epithelialized patch of bowel was shaped as a cup patch and anastomosed to the edges of the detrusor muscle over the bulging urothelium. The animal s were sacrificed at 12 months of followup. All bladders were inspected mac roscopically for regrowth of the colonic mucosa. Multiple sections of the a ugmentation patches were obtained and processed routinely for histological evaluation to determine what happened to the urothelium. Results: We noted good urodynamic results in all dogs and there was no stat istical difference in the groups in regard to bladder capacity. Mucosal reg rowth did not develop in either group. Conclusions: When dissection is performed successfully whether or not the s ubmucosa is removed, there is no observed regrowth or loss of bladder capac ity in either technique.