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Related Concept Videos

Urinary Bladder01:23

Urinary Bladder

The urinary bladder is a hollow, muscular sac that temporarily stores urine before it is expelled from the body. It can hold approximately 600 mL of urine prior to micturition. The bladder is retroperitoneal and located behind the pubic symphysis in the pelvic floor.
In males, the bladder is situated in front of the rectum, while in females, it is positioned anterior to the vagina and uterus. The bladder floor contains an inverted triangular area called the trigone, defined by the two ureteric...

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Paediatric bladder augmentation and substitution: From diversions to tissue engineering.

John Grant Pike1

  • 1Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario.

Paediatrics & Child Health
|January 5, 2010
PubMed
Summary

Urinary diversion, augmentation, and replacement in children have evolved significantly. While bowel segments remain the standard, complications drive research into tissue engineering for better bladder reconstruction alternatives.

Keywords:
Bladder augmentationBladder substitutionUrinary diversion

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Published on: August 9, 2012

Area of Science:

  • Pediatric Urology
  • Reconstructive Surgery
  • Biomaterials Science

Background:

  • Bladder reconstruction is necessary in children due to congenital issues, disease, or trauma.
  • The unique properties of urothelium and bladder muscle present challenges in reconstruction.
  • Management has shifted from complete urinary diversion to organ preservation.

Purpose of the Study:

  • To review the historical evolution of pediatric urinary diversion, bladder augmentation, and replacement techniques.
  • To outline potential future directions in pediatric bladder management.
  • To analyze the challenges and advancements in bladder reconstruction materials and methods.

Main Methods:

  • Literature review of English-language publications from 1970-2001.
  • PubMed search using terms: "bladder augmentation", "bladder substitution", "bladder autoaugmentation", "ureterocystoplasty", "bladder engineering".
  • Analysis focused on complications and evolution of materials/techniques in pediatric patients (0-18 years).

Main Results:

  • Gastrointestinal tract segments are historically and currently used for bladder reconstruction.
  • Bowel use is associated with complications: mucus, stones, metabolic issues, growth retardation, perforation, and malignancy.
  • Despite drawbacks, bowel remains the functional gold standard, prompting research into natural and synthetic alternatives.
  • Tissue engineering shows promise for future bladder replacement or repair.

Conclusions:

  • Bowel segments are the most clinically useful materials for pediatric urinary diversion, augmentation, and replacement.
  • Complications from bowel use necessitate ongoing research into alternative materials and surgical methods.