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] 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
or bladder outlet surgery.
Gil et al., "The performance of silk scaffolds in a rat model of augmentation cystoplasty
," Biomaterials, vol.
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.