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Experience with demucosalized ileum for bladder augmentation
S V Lima1, L A Araújo, F O Vilar
1Hospital das Clínicas, Federal University of Pernambuco, Recife, Brazil.
Objective:
To assess the use of demucosalized ileum for bladder augmentation, following the same principles previously used with the sigmoid colon.
Patients And Methods:
Eleven patients with bladder exstrophy or a neurogenic bladder had their bladders augmented with demucosalized ileum instead of the sigmoid colon, but following the same technique. The use of a Foley catheter with an inflated balloon greatly facilitated the dissection of the mucosa from the muscle. A silicone model, inserted in the bladder, was used to avoid shrinkage of the patch. An animal model was also used for total bladder replacement following the same principle.
Results:
The mean (range) follow-up was 15.4 (2-25) months. There was a significant increase in bladder compliance in all patients. A bladder of good shape and compliance was obtained in the animal model, with epithelial growth detected in all cases.
Conclusions:
Demucosalized ileum can be used safely for bladder augmentation in the same way as with the sigmoid colon. The distension of the isolated patch greatly facilitates dissection between the mucosa and muscle. The animal model supported this method of bladder replacement.