Routine surveillance cystoscopy for patients with augmentation and substitution
cystoplasty for benign urological conditions: is it necessary?
Hakenberg, "Re: tissue-engineered autologous bladders for patients needing
cystoplasty," European Urology, vol.
The continence mechanism of female patients with total pelvic exenteration and pelvic autonomic nerve preservation after ileal
cystoplasty functions well.[sup][4] We consider that preserving nerves intraoperatively might result in a slightly high urinary continence rate, but complete tumor resection is important for patients.
When these bladder conditions are refractory to conservative therapy, augmentation
cystoplasty is required to preserve renal function.
Nephrectomy/nephroureterectomy 12 Pyeloplasty 1 Ureteral reconstruction 8 Ureteroureterostomy 2 Psoas hitch 3 Boari flap 1 Ileal ureter 2 Augmentation
cystoplasty 9 Ileocystoplasty 6 Sigmoid colocystoplasty 2 Ileocystoplasty + ileal ureter 1 Epididymectomy 3 Visual internal urethrotomy 2
augmentation
cystoplasty or bladder outlet surgery.
The utilization of the ureter in augmentation
cystoplasty results in a uroepithelium-lined neobladder with all of the appropriate histologic layers.
The choice of a suitable scaffold for cell delivery and /or the ingrowths of bladder wall components are recognized as one of the key factors that determine regenerative capacities and graft function in augmentation
cystoplasty. The engineered scaffold must provide optimal structural integrity to withstand in-vivo requirements and appropriate regulation of cell behaviour (5).
The most common surgical option, augmentation
cystoplasty, involves placing a "patch" derived from an individual's bowel over a part of the diseased organ in order to increase its size.
(17) Anthony Atala et al, "Tissue-Engineered Autologous Bladders for Patients Needing
Cystoplasty" (2006) 367:9518 Lancet 1241.
More recently Atala et al (2006) have reported of the use of autologous urothelial and smooth muscle cells seeded onto collagen and polyglycolic acid composite matrices and used for augmentation
cystoplasty in clinical trials in seven patients.