Rectus abdominis muscle flap (RAMF) technique for the management of large bladder defects: urodynamic findings in a rabbit model.
OBJECTIVE
To investigate the efficacy of the rectus abdominis muscle flap (RAMF) technique for the closure and augmentation of small, inelastic bladder extrophies using a rabbit model with a large bladder defect.


METHODS
Fifteen New Zealand White rabbits were studied in two groups; nine rabbits in group 1 underwent resection of 65% of the bladder and then bladder augmentation using a full-thickness RAMF, including peritoneum, and six rabbits in group 2 (control) underwent a similar bladder resection but the bladder remnant was closed primarily. Urodynamic investigations were carried out in both groups preoperatively and 4 weeks after surgery. Intravenous pyelography (IVP), voiding cystourethrography (VCUG), urodynamic and histopathological investigations were also carried out for up to 4 months after surgery.


RESULTS
As assessed by IVP, the urinary system appeared normal, with no signs of upper urinary tract dilatation and VCUG showed a normal voiding pattern. After surgery, the bladder capacity and compliance decreased in both groups, but both variables partially recovered in group 1, although not significantly.


CONCLUSIONS
This animal model indicates that the RAMF technique is a suitable alternative for the management of large bladder defects and bladder exstrophies with small, inelastic, non-compliant bladders.
Celayir
S
S
Department of Paediatric Urology, Cerrahpasa Medical Faculty, University of Istanbul, Turkey.
Kiliç
N
N
Dervisoglu
S
S
Büyükünal
C
C
D000818:Animals; D001746:Bladder Exstrophy / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D011312:Pressure; D011817:Rabbits; D017568:Rectus Abdominis / Q000637:transplantation*; D013524:Surgical Flaps; D014554:Urination / Q000502:physiology; D014563:Urodynamics / Q000502:physiology*