title: Augmentation cystoplasty and extracellular matrix scaffolds: an ex vivo comparative study with autogenous detubularised ileum.
abstract: BACKGROUND
  Augmentation cystoplasty (AC) with autogenous ileum remains the current gold standard surgical treatment for many patients with end-stage bladder disease. However, the presence of mucus-secreting epithelium within the bladder is associated with debilitating long-term complications. Currently, decellularised biological materials derived from porcine extracellular matrix (ECM) are under investigation as potential augmentation scaffolds. Important biomechanical limitations of ECMs are decreased bladder capacity and poor compliance after implantation.
  
  
  RESULTS
  In the present ex vivo study a novel concept was investigated where a two-fold increase in ECM scaffold surface-area relative to the resected ileal segment was compared in ovine bladder models after AC. Results showed that bladder capacity increased by 40 ± 4% and 37 ± 11% at 10 mmHg and compliance by 40.4 ± 4% and 39.7 ± 6% (ΔP = 0-10 mmHg) after AC with ileum and porcine urinary bladder matrix (UBM) respectively (p < 0.05). Comparative assessment between ileum and UBM demonstrated no significant differences in bladder capacity or compliance increases after AC (p > 0.05).
  
  
  CONCLUSIONS
  These findings may have important clinical implications as metabolic, infective and malignant complications precipitated by mucus-secreting epithelium are potentially avoided after augmentation with ECM scaffolds.
authors.affiliation: Department of Urology, Mid-Western Regional Hospital, Limerick, Ireland.
authors.forename: Niall F
authors.initials: NF
authors.lastname: Davis
authors.forename: Rory
authors.initials: R
authors.lastname: Mooney
authors.forename: Anthony
authors.initials: A
authors.lastname: Callanan
authors.forename: Hugh D
authors.initials: HD
authors.lastname: Flood
authors.forename: Tim M
authors.initials: TM
authors.lastname: McGloughlin
mesh_terms: D000818:Animals; D001696:Biomechanical Phenomena; D005109:Extracellular Matrix / Q000378:metabolism*; D005260:Female; D007082:Ileum / Q000601:surgery; D012756:Sheep; D013552:Swine; D023822:Tissue Engineering; D054457:Tissue Scaffolds; D001743:Urinary Bladder / Q000378:metabolism / Q000502:physiology / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*