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Autoaugmentation gastrocystoplasty and demucosalized gastrocystoplasty in a sheep model
P A Dewan1, W Stefanek, C Lorenz
1Urology Unit, Women's and Children's Hospital, Adelaide, South Australia.
Objectives:
To compare the normal sheep bladder at 6 and 12 months with bladders subjected to either an autoaugmentation gastrocystoplasty or a clam demucosalized gastrocystoplasty.
Methods:
Twenty male lambs aged between 8 and 10 weeks had an autoaugmentation gastrocystoplasty in which de-epithelialized stomach muscle was added to an intact urothelium. The functional, radiologic, and histologic outcomes were compared with 11 animals who underwent a clam demucosalized gastrocystoplasty and 14 control animals. A total of 18 operated animals had a urodynamic study at 6 months and 9 at 12 months.
Results:
The average bladder volume for the autoaugmentation gastrocystoplasty group at 12 months was greater than that of the control group (401 +/- 120 mL versus 205 +/- 77 mL). The demucosalized clam bladders had been less effectively enlarged (286 +/- 77 mL). The compliance values for autoaugmentation gastrocystoplasty animals were 14.7 +/- 11.3 mL/cm water (H2O) compared with 9.0 +/- 4.8 mL/cm H2O in the demucosalized gastrocystoplasty group, and 9.1 +/- 3.7 mL/cm H2O for the control animals.
Conclusions:
The addition of the autoaugmentation procedure improves the prospect of enlarging the normal sheep bladder when using demucosalized gastric muscle.