Augmentation Cystoplasty Utilizing De-Epithelialized Sigmoid Colon: A Preliminary Study

Abstract

The use of bowel segments for bladder replacement or augmentation has been associated with metabolic complications and obstruction due to mucus production. Establishment of a transitional epithelium over the de-epithelialized surface of a segment of intestine might alleviate these complications Twenty Holstein bull calves underwent sigmoidocystoplasty. Fourteen experimental animals had the epithelium of the sigmoid removed before augmentation. Six calves with intact mucosa served as controls. Fifteen calves survived the study: 11 experimentals and four controls. Cystectomies were performed at four, six, eight, or 12 weeks. Ninety-one percent (10/11) of the experimental calves had almost complete epithelialization of the de-epithelialized graft. All experimental animals had residual colonic mucosa or mucoceles. Nine of 11 experimental calves (82%) had greater than 25% contracture of the sigmoid graft. Two animals had less than 25% graft contracture (1) or formed a wide-mouthed true diverticulum (1) in the grafted segment. All control animals formed a wide-mouthed true diverticulum and had no graft contracture.