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Gastropyeloplasty: a swine model.

N S Schenkman1, J Costa, D A Belote

  • 1Naval Medical Center, Portsmouth, Virginia, USA.

Urology
|March 30, 1999
PubMed
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Transferring a gastric patch to the renal pelvis did not acidify urine in pigs. This surgical approach for preventing struvite stones led to hydronephrosis and ureteral dilation.

Area of Science:

  • Urology
  • Surgical Innovation
  • Nephrolithiasis Research

Background:

  • Struvite calculus formation is linked to alkaline urinary pH.
  • Acidic urine dissolves struvite calculi and prevents recurrence.
  • Previous long-term urinary acidification methods have been unsuccessful.

Purpose of the Study:

  • To investigate the potential of a gastric patch with viable parietal cells anastomosed to the renal pelvis for creating an acidic urinary milieu.
  • To develop an animal model for evaluating gastric patch transfer to the renal pelvis.

Main Methods:

  • A vascularized stomach patch was anastomosed to the left renal pelvis in female pigs (n=9).
  • Urine pH was measured before and after pentagastrin stimulation and oral intake.
  • Kidneys, ureters, and bladders underwent gross examination and histologic review.

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Main Results:

  • The gastric patch kidney exhibited less acidic urine compared to the control kidney.
  • Pentagastrin stimulation did not significantly alter urinary pH.
  • Hydroureteronephrosis and a concentrating defect were observed in the treated kidney; smooth muscle hyperplasia of the ureter was noted histologically.

Conclusions:

  • The developed animal model demonstrated that gastric patch transfer to the renal pelvis did not acidify urine.
  • Associated complications included hydronephrosis and ureteral dilation.
  • Further research is needed to refine the concept for potential prevention of recurrent struvite nephrolithiasis.