Laparoscopic augmentation cystoplasty: a comparison between native ileum and small intestinal submucosa in the porcine model

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To determine the feasibility of laparoscopic augmentation cystoplasty (LAC) in the porcine model and to compare LAC using standard bowel vs a small intestinal submucosa (SIS) allograft. Fourteen female pigs underwent LAC; six had standard ileal AC and eight AC with SIS. All the pigs had limited cystometrogram studies before surgery to determine bladder capacity. At 6 weeks after surgery the pigs were anaesthetized, the bladder capacities were re-assessed and then the pigs were killed; the bladders were harvested and examined histologically. In all, 12 of 14 pigs completed the 6-week survival period; two pigs from the SIS group died from urinary ascites secondary to anastomotic leaks at the cystoplasty site. There were no complications in the ileal augmentation group. The operative duration was similar in both groups. The bladder capacities increased significantly in both groups, although more reliably in the native ileum group. In two pigs in the SIS group there was no increase in bladder capacity. LAC is feasible in the porcine model and results in a significant increase in bladder capacity. AC using SIS does not appear to increase bladder capacity as reliably as native ileum, and has a higher complication rate.