Limits...
Augmentation cystoplasty and extracellular matrix scaffolds: an ex vivo comparative study with autogenous detubularised ileum.

Davis NF, Mooney R, Callanan A, Flood HD, McGloughlin TM - PLoS ONE (2011)

Bottom Line: 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).

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Mid-Western Regional Hospital, Limerick, Ireland.

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.

Methodology/principal findings: 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.

Show MeSH

Related in: MedlinePlus

Comparative illustration of bladder capacity (ml) at baseline and after AC with ileum (A) and UBM (B).AC, augmentation cystoplasty.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3102100&req=5

pone-0020323-g004: Comparative illustration of bladder capacity (ml) at baseline and after AC with ileum (A) and UBM (B).AC, augmentation cystoplasty.

Mentions: Baseline and ileocystoplasty capacity values are summarised in Table 3. Baseline capacity values ranged from 125±17 ml at 2 mmHg to 240±45 ml at 10 mmHg and ileocystoplasty values ranged from 175±25 ml at 2 mmHg to 336±56 ml at 10 mmHg. Ovine bladders that underwent AC with autogenous ileum demonstrated a significant increase in bladder capacity at 2, 4, 6, 8 and 10 mmHg (Fig. 4a, p<0.01). Volumetric increases ranged from 51±9 ml at 2 mmHg to 96±13 ml at 10 mmHg. Bladder compliance measured at 10 mmHg was also significantly increased after AC with ileum (40.4±4%, p<0.01). Compliance values ranged from 24±5 ml/mmHg at baseline (ΔP = 0–10 mmHg) and increased to 34±6 ml/mmHg (ΔP = 0–10 mmHg) post AC with ileum (Table 4).


Augmentation cystoplasty and extracellular matrix scaffolds: an ex vivo comparative study with autogenous detubularised ileum.

Davis NF, Mooney R, Callanan A, Flood HD, McGloughlin TM - PLoS ONE (2011)

Comparative illustration of bladder capacity (ml) at baseline and after AC with ileum (A) and UBM (B).AC, augmentation cystoplasty.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3102100&req=5

pone-0020323-g004: Comparative illustration of bladder capacity (ml) at baseline and after AC with ileum (A) and UBM (B).AC, augmentation cystoplasty.
Mentions: Baseline and ileocystoplasty capacity values are summarised in Table 3. Baseline capacity values ranged from 125±17 ml at 2 mmHg to 240±45 ml at 10 mmHg and ileocystoplasty values ranged from 175±25 ml at 2 mmHg to 336±56 ml at 10 mmHg. Ovine bladders that underwent AC with autogenous ileum demonstrated a significant increase in bladder capacity at 2, 4, 6, 8 and 10 mmHg (Fig. 4a, p<0.01). Volumetric increases ranged from 51±9 ml at 2 mmHg to 96±13 ml at 10 mmHg. Bladder compliance measured at 10 mmHg was also significantly increased after AC with ileum (40.4±4%, p<0.01). Compliance values ranged from 24±5 ml/mmHg at baseline (ΔP = 0–10 mmHg) and increased to 34±6 ml/mmHg (ΔP = 0–10 mmHg) post AC with ileum (Table 4).

Bottom Line: 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).

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Mid-Western Regional Hospital, Limerick, Ireland.

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.

Methodology/principal findings: 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.

Show MeSH
Related in: MedlinePlus