Nonsecretory sigmoid cystoplasty: experimental and clinical results

We report the results of experimental and clinical studies in which a de-epithelialized segment of sigmoid colon was used to cover the bladder dome where the mucosa was exposed (auto-augmentation) to increase bladder capacity. Experimentally, the technique was performed in 10 healthy female mongrel dogs and the intestinal segments established continuity perfectly over the exposed bladder mucosa. Histology 30 and 60 days postoperatively showed transitional epithelium lining the intestinal segment at the site of implantation. One island of intestinal mucosa was found. The technique was performed in 10 patients, including 9 with neurogenic bladder secondary to myelomeningocele and 1 with posterior urethral valves. Bladder capacity improved in all cases and intravesical pressure was reduced. Followup ranged from 6 to 43 months. The technique is proposed as a valuable alternative to traditional full-thickness patches of the digestive tract and auto-augmentation.