Urinary bladder auto augmentation using INTEGRA and SURGISIS: an experimental model.
OBJECTIVE
We present our experience with an experimental urinary bladder auto augmentation model using SURGISIS and INTEGRA (collagen layer) in comparison with seromuscular enterocystoplasty. The aim of the study was to evaluate the change in compliance and elasticity of the urinary bladder.


METHODS
Eighteen lambs were divided into three different groups. Auto augmentation was performed using the seromuscular layer of small bowel, SURGISIS or the collagen layer of INTEGRA. After 3 months of the initial procedure, the lambs were re-operated, the bladder compliance was measured and the urinary bladder was submitted for histological examination and assessment of elasticity. The lambs were euthanized.


RESULTS
The postoperative period was uneventful in 17 lambs except for intestinal obstruction in one lamb from the seromuscular enterocystoplasty group. A statistically significant difference in compliance was observed with SURGISIS and the INTEGRA. Histologically, there was neovascularization in all the specimens from the SURGISIS and INTEGRA groups with the presence of fibrosis in the SURGISIS group. The INTEGRA group showed better elastic properties than the SURGISIS.


CONCLUSIONS
Urinary bladder auto augmentation using the collagen layer of INTEGRA showed better functional and histological results when compared with SURGISIS and demucosalized enterocystoplasty in the present model.
Parshotam Kumar
Gera
G
Princess Margaret Hospital for Children, Perth, Australia. gerapk@rediffmail.com
Barker
Andrew
A
Ahmed
Saeed
S
Gerath
Jevon
J
Orford
Jillian
J
D020341:Absorbable Implants; D000818:Animals; D002809:Chondroitin Sulfates; D003094:Collagen; D004548:Elasticity; D005260:Female; D007421:Intestine, Small / Q000098:blood supply / Q000637:transplantation*; D023421:Models, Animal; D009852:Omentum / Q000098:blood supply / Q000637:transplantation; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000379:methods*; D012756:Sheep; D018709:Statistics, Nonparametric; D014020:Tissue Extracts; D001743:Urinary Bladder / Q000601:surgery*
D014020:Tissue Extracts; C114835:integra artificial skin; D002809:Chondroitin Sulfates; D003094:Collagen