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Evaluation of a bladder advancement extension graft technique
R A Gardiner1, G A Mills, L P Rivory
1Department of Surgery, Royal Brisbane Hospital, Australia.
British Journal of Urology
|December 1, 1990
Summary
A novel bladder advancement technique creates extra bladder length for ureteric reconstruction. This method, along with omental grafts for potential stenosis, proved effective in canine studies, preventing obstruction.
Area of Science:
- Urology
- Surgical Innovation
- Regenerative Medicine
Background:
- Significant proximal ureteric deficiencies pose challenges for reconstructive surgery.
- Existing techniques like Boari flap and psoas hitch may have limitations in length accommodation.
Purpose of the Study:
- To develop and evaluate a bladder advancement extension technique for enhanced ureteric reconstruction.
- To establish a secondary omental graft procedure for potential complications.
Main Methods:
- A bladder advancement extension technique was created in 10 dogs.
- Omentally supported bladder grafts were prepared for retrieval procedures.
- Animals were studied for 6 months, assessing graft patency and ureteric function.
Main Results:
- The bladder advancement technique provided sufficient length for ureteric reconstruction.
- Two dogs required retrieval grafts due to stenosis at the extension graft/upper ureteric junction.
- Grafts demonstrated healthy urothelium and muscle, and no upper tract obstruction was observed.
Conclusions:
- The bladder advancement extension technique offers a reliable solution for significant proximal ureteric defects.
- The omentally supported graft serves as a viable option for managing subsequent stenosis.
- The technique shows promise for routine use in complex ureteric reconstructions.