Long-term follow-up and evaluation of autoaugmentation cystoplasty (detrusorotomy) in an animal model.

Abstract

To evaluate long-term follow-up of an autoaugmentation (detrusorotomy) technique, in puppies. In 10 mongrel puppies, bladder capacities were reduced to nearly half their original volume by 10 per cent formalin instillations. In 7 puppies, the muscular coat of the bladder was split open widely down to the mucosal layer, from the bladder neck anteriorly, to the trigone posteriorly while the mucosa was kept exposed and intact. Three puppies were kept as controls. Mean post-instillation bladder capacity was 15.40 ml. One week after detrusorotomy the bladder capacity averaged up to 20.00 ml; 3 weeks later up to 20.43 ml; and 3 months later up to 34.28 ml and were well up to 3 months. However, at the termination of an additional 9-month period, the bladders of 4 of the remaining five dogs were seen to decrease in volume except the one with an accidental omental adherence to the exposed mucosa which kept the detrusorotomy intact. Post-detrusorotomy volume could be retained if a graft, e.g. omentum, gut segment, amniotic membrane or lyophilized dura is inserted at the time of intervention, in-between the split musculature to line the exposed mucosa externally and to prevent re-adhesion of the muscular edges.