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Glutaraldehyde cross-linked bovine collagen in exstrophy/epispadias complex
P Caione1, A Lais, M de Gennaro
1Department of Pediatric Surgery, Bambino Gesù Children's Hospital, Rome, Italy.
The Journal of Urology
|August 1, 1993
Summary
Cross-linked bovine collagen injections improved continence in children with bladder exstrophy and epispadias. This minimally invasive treatment increased bladder capacity, potentially avoiding major surgery.
Area of Science:
- Urology
- Pediatric Surgery
Background:
- Children with bladder exstrophy and epispadias often experience urinary incontinence.
- Previous surgical interventions like the Young-Dees operation may not fully restore continence.
- Small bladder capacity can be a significant challenge after lower urinary tract reconstruction.
Purpose of the Study:
- To evaluate the efficacy of cross-linked bovine collagen injections in improving urinary continence and bladder capacity in pediatric patients.
- To assess collagen injections as an alternative to augmentation cystoplasty for increasing bladder volume.
Main Methods:
- Endoscopic submucosal injection of cross-linked bovine collagen into the urethra or bladder neck.
- Injections were administered to children with epispadias, bladder exstrophy, and post-Young-Dees incontinence.
- Collagen was also injected before bladder neck surgery to enhance outlet resistance and bladder capacity.
Main Results:
- Continence improved in 9 out of 10 children treated after bladder neck surgery.
- Bladder capacity increased by an average of 47% over 2 years in 5 out of 6 children treated before reconstruction.
- One patient experienced a failure of the procedure.
Conclusions:
- Submucosal collagen injection is a valuable tool for modulating outflow resistance and increasing bladder volume in pediatric patients.
- This technique offers a potential alternative to augmentation cystoplasty for patients with small bladders post-exstrophy closure.