Bladder Cellular Regeneration after Augmentation Cystoplasty with Human Dura Mater (Tutoplast(R)) in Rat

Ro, Dong Woo; Kim, Kap Byung; Kim, Duk Youn

Abstract

PURPOSE: To study the cellular events occuring during bladder development and regeneration, we used the human Dura mater (Tutoplast(R)) for augmenting the rat bladder. We compared their intravesical threshold pressure and volume, and observed the regenerative capacity of urothelium and smooth muscle cell within Tutoplast(R).
MATERIALS AND METHODS
Among a total of 67 rats, 11 normal rats were checked their intravesical threshold pressure and volume(Group 1). 9 rats underwent only vesicotomy(Sham operation) and were checked their threshold pressure and volume at 2 months and 3 months postoperatively(Group 2). 47 rats underwent augmentation cystoplasty with Tutoplast(R) after partial cystectomy, which were checked pressure and volume at 1 day, 3-7 days, 2-4 weeks, 2-6 months postoperatively(Group 3). Specimens were examined histologically to assess the regeneration of urothelium and smooth muscle cell on the graft.
RESULTS
There was a significant increase in intravesical volume of group 3 compared with group 1 and 2. There was a significant decrease in intravesical pressure of group 3 compared with group 2, but there was no significant difference between group 1 and 3. The specimens of 1 day postopratively showed inflammatory findings. Epithelialization on the graft margin was noted at 3 days postoperatively. At 7 days postoperatively, there was epithelial hyperplasia on the graft site. At 2 weeks postoperatively, there was a partial absorption of Tutoplast(R) as well as favorable progression of epithelialization. Smooth muscle regeneration and complete epithelialization were shown at 3 months postoperatively and absorption of Tutoplast(R) was completed thereafter.
CONCLUSIONS
The regeneration of bladder cellular constituents within Tutoplast(R) will be valuable for further understanding the mechanism controlling bladder development and regeneration. Further studies will be necessary for using this method as an alternative strategy to the classical bladder augmentation.