Availability of Reversed Seromuscular Flaps in the Enterocystoplasty in Rats

Kang, Taek Won; Kwon, Dong Deuk; Ryu, Soo Bang

Abstract

PURPOSE: Enterocystoplasty is the method commonly used in clinical practice. The use of intestinal segments in the urinary tract for the reconstructive purposes has been reported numerous complications: urinary tract infection, stone formation, hyperchloremic acidosis, hypokalemia, urinary obstruction secondary to mucus plugs, and malignancy developing. We studied on the feasibility of creating an enterocystoplasty with a reversed seromuscular ileal segment to decrease the likelihood of recognized complications in cases of standard bowel replacement.
MATERIALS AND METHODS
Augmentation enterocystoplasty was performed in 21 male, 400-450gm, Sprague-Dawley rats with a patch of ileum. There were 3 groups, including 1 group of 9 rats that underwent augmentation conventionally, while another group of 8 rats were augmented using reversed seromuscular flaps and the other rat was died for postoperative ileus. The other group of 3 rats were sham operated. The animals survived without significant complications and were sacrificed at 4 or 12 weeks.
RESULTS
The bladder capacities in both group were no significant differences. The size of the intestinal patchs were markedly decreased in reversed seromuscular flaps. The urine white blood cells and mucus production were much higher in the conventional type, but intraperitoneal mucus production and postoperative adhesion were seen mostly in reversed seromuscular types.
CONCLUSIONS
Reversed seromuscular flaps showed little mucus production in urine and urinary infection compared to those animals with flaps undergone conventional method. Unfortunately, intraperitoneal mucus production and graft contracture were much higher in those procedures. Further studies would be needed for clinical availability of reversed flap.