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was similar to native bladder muscle layers after 9 months of transplantation in all animals. CD34
endothelial progenitor cells, CD31 microvessels, α-smooth muscle actin (α-SMA), S100, cytokeratin
AE1/AE3, vimentin, and synaptophysin were expressed highly in immunohistochemical staining
after 9 months of operation.
CONCLUSIONS
The results confirmed that decellularized bladder can be considered as a reliable natural scaffold
and viable material for bladder augmentation in rats and rabbits.
14:21–14:24
S1-11 (PP)
URINARY BLADDER AUTO-AUGMENTATION:
HOMOLOGOUS USE OF A DECELLULARISED
BIOMATERIAL
Debora MORGANTE
1
, Syed Khawar ABBAS
2
, Jennifer HINLEY
1
, Eileen INGHAM
3
,
Jennifer SOUTHGATE
1
and Ramnath SUBRAMANIAM
4
1) University of York, Biology, York, UNITED KINGDOM - 2) University of Leeds, Central Biomedical Services, Leeds,
UNITED KINGDOM - 3) University of Leeds, Institute of Medical and Biological Engineering, Leeds, UNITED KINGDOM
- 4) University of Leeds, Paediatric Urology, Leeds, UNITED KINGDOM
PURPOSE
New approaches are needed to improve the clinical outcome and quality of life in paediatric
patients with severely contracted, fibrotic and thickened-wall urinary bladders. Numerous surgical
techniques have been proposed including auto-augmentation, where the detrusor muscle is split
to allow the urothelium to bulge, increasing bladder capacity and compliance. Although considered
a useful intervention when performed in the pre-end-stage failing bladder, the risk of perforation has
inhibited widespread uptake of the technique. In this study, we report the use of a porcine acellular
bladder matrix (PABM: Bolland et al. Biomaterials 2007; 28(6):1061–70) to support the exterior
aspect of the auto-augmented bladder in a large animal surgical model.
MATERIAL AND METHODS
PABM was produced from full thickness porcine bladders. Six large landrace female pigs (average
weight: 23.65 kg) underwent urinary bladder auto-augmentation, the defect then being covered
with 4x3 cm patch of PABM over the bulging mucosa and held in place by absorbable sutures. The
tissue histology was investigated post-mortem in animals after a four month follow-up.
RESULTS
No intra-operative complications occurred and all pigs recovered and voided normally post-oper-
atively. Five animals were followed-up for 4 months, but one animal was sacrificed after 18 days
due to development of a small bowel perforation. All six bladders were recovered and histology
showed that the patch material had undergone at least partial cellular integration, with no evidence
of inflammation.
CONCLUSIONS
Strength and compliance properties of PABM make it an ideal biomaterial in reconstructive uro-
logical surgery. These first surgical results suggest an application for PABM in homologous urinary
bladder auto-augmentation.