REGENERATION OF THE BLADDER WITH COLLAGEN GRAF AND SILICON STENT

Abstract

A) PURPOSE: Augmentation cystplasty is used for treatment of reduce bladder capacity and compliance secondary to infectious, inflammatory, neurogenic and congenital disorders. The application of various artificia materials has been attemped in the urinary tract but such attempts hav generally failed due to mechanical, structual, or biocompatibility problems. The use of gastrointestinal segments for bladde reconstruction is unavoidablly linked with potential complications suc as mulnutrition, metabolic disturbance, surgical complication, mucu production and cancer formation. The present study investigates th feasibility of replacing the resected bladder wall with a newly develope collagen graft in partial cystectomy models in canines. B) METHOD: Composite grafts comprised of a sandwich-like structure o thin polygractic acid (PGA) mesh inserted between two collagen layer were used. Eight beagle dogs underwent 2±2 cm partial cystectomy an grafting with equally sized collagen/PGA grafts. Prior to grafting, silicon sheet was placed intraluminally to protect the graft from urine The grafts were preclotted with autologous peripheral blood o autologous bone marrow. Silicon sheets were removed 4–6 weeks afte operation. C) RESULT: All dogs survived in good health until they were sacrificed a 2 to 4 months. Graft shrinkage was minimum and the bladder mucos was regenerated by 2 months. Partial muscle regeneration and bone-lik formation were seen at 2 months. Alpha smooth muscle actin stainin reconfirmed the regeneration of the muscle on the bladder wall. Thes results indicate that the use of this method shows promise as a ne strategy for bladder reconstruction.