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Acute ureteral elongation in two animal models using a balloon expander
E R Goldfischer1, K G Stravodimos, M E Jabbour
1Department of Urology, Long Island Jewish Medical Center, New Hyde Park, New York, USA.
Journal of Endourology
|July 16, 1999
Summary
Tissue expanders can acutely elongate the ureter by over 30% in animal models. This novel technique shows promise for repairing ureteral injuries with less invasive surgery.
Area of Science:
- Urology
- Regenerative Medicine
- Surgical Innovation
Background:
- Ureteral injuries and strictures often require complex reconstructive surgeries.
- Existing reconstructive techniques include psoas hitch, Boari flap, and ileal interposition.
- Tissue expanders have demonstrated utility in elongating other tubular structures like nerves and arteries.
Purpose of the Study:
- To evaluate the feasibility and effects of acute ureteral elongation using a tissue expander.
- To assess the viability and functional outcomes of the ureter after acute elongation in animal models.
Main Methods:
- Acute ureteral elongation was performed using a Ruiz-Cohen balloon expander in rabbits and pigs.
- In pigs, ureteroureterostomy was conducted after acute expansion of an excised segment.
- Histopathological examination and intravenous urography were used to assess ureteral integrity and function.
Main Results:
- Achieved significant acute ureteral elongation, averaging 31.3% in rabbits and 32.0% in pigs.
- Post-elongation urography at 6 weeks confirmed a functioning kidney and patent ureter.
- Histology revealed viable ureteral tissue with intact epithelium and normal muscular layers, showing only mild inflammation at 6 weeks.
Conclusions:
- Acute ureteral elongation with a tissue expander is a viable new method for increasing ureteral length.
- This technique may offer a less morbid alternative for managing ureteral defects currently requiring major reconstructive surgery.