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Beyond The Abstract: Nonsecretory Intestinocystoplasty: A 15-Year Prospective Study Of 183 Patients

UroToday.com - Improving bladder capacity and compliance by surgical methods continues to be challenging specially for children and young adults with long life expectancy. Although segments of the digestive tract from stomach to sigmoid colon present satisfactory results in terms of obtaining a compliant reservoir the long-term complications rates are significantly high. The specific characteristics of the digestive mucosa are responsible for the development of bladder stones and malignancies in all segments used. Spontaneous bladder perforation has been also a serious event in some of these patients.

The present prospective study of 183 bladder augmentations shows a different outcome for patients that underwent bladder augmentation utilizing de-epithelialized segments of ileum and colon. The occurrence of stones and spontaneous bladder perforation was significantly lower in the long-term follow up when compared to similar series with total intestinal patches. No cases of malignancies were found. The occurrence of failures related to loss of compliance (12.6%) is higher than the traditional methods but not statistically significant.

There are a few reports in the literature of the use of demucosalized patches that present a higher number of failures than what was found in this study. The explanation is in the technique used by the authors with focus on the process of removing the mucosa and early distension of the patch to avoid shrinkage. It is expected that the improvement in the techniques of cell cultures will allow in the near future the use of re-epithelialized patches thus reducing the failure rates of this procedure.

Written by Salvador Vilar C. Lim, MD, PhD, as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations, etc., of their research by referencing the published abstract.

Link to Full Abstract

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Dincolo de Rezumat: Nonsecretory Intestinocystoplasty: 15-Anul Un studiu prospectiv Din Pacienþii 183 - Beyond The Abstract: Nonsecretory Intestinocystoplasty: A 15-Year Prospective Study Of 183 Patients - articole medicale engleza - startsanatate