Experimental Bladder Reconstruction
(2007)- Abstract
- Reduced urinary bladder capacity is a clinically significant problem. The surgical methods that have been available to treat this, such as urinary diversion or surgically augmenting the bladder by incorporation of intestinal segments, all have serious drawbacks. There is a need to understand how the smooth muscle of the intestine and bladder can interact when brought into close contact surgically, and also to develop methods to reconstruct the bladder without using intestinal segments.
The experiments on bladder reconstruction performed in this study ? regeneration after subtotal cystectomy, replacement with bowel segments and matrix grafts ? show that the bladder has a high capacity for regenerative growth. After... (More) - Reduced urinary bladder capacity is a clinically significant problem. The surgical methods that have been available to treat this, such as urinary diversion or surgically augmenting the bladder by incorporation of intestinal segments, all have serious drawbacks. There is a need to understand how the smooth muscle of the intestine and bladder can interact when brought into close contact surgically, and also to develop methods to reconstruct the bladder without using intestinal segments.
The experiments on bladder reconstruction performed in this study ? regeneration after subtotal cystectomy, replacement with bowel segments and matrix grafts ? show that the bladder has a high capacity for regenerative growth. After enterocytstoplasty, nerves from the bladder grow into the intestinal segment, in which ganglionic atrophy appears.This is a possible explanation to the shift in pharmacological properties shown to occur in such segments with time, a phenomenon also found in our experiments. The cystometric findings in animals operated with enterocystoplasty suggest that the bowel segment, at least to some degree, participates in the emptying of the bladder, i.e. the intestinal muscle is functionally integrated into the bladder wall and not merely a passive part during emptying. The findings after subtotal cystectomy show that the rat bladder can produce new, contracting muscle, although with lowered maximal shortening velocity and lowered maximal force production ability compared to controls. The nerves found in the bladder developing after subtotal cystectomy represent growth and branching of pre-existing nerves. The nerves found in the small intestinal submucosa matrix grafts are a continuation of nerve trunks from the bladder reaching the grafts at the suture line. The nerve trunks and muscle bundles in the subtotally cystectomized bladders and in the matrix grafts do not fully attain the growth pattern found in normal bladders. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/598890
- author
- Frederiksen, Hans LU
- supervisor
- opponent
-
- Prof. Levin, Robert M., Albany College of Pharmacy, Albany, New York, USA
- organization
- publishing date
- 2007
- type
- Thesis
- publication status
- published
- subject
- keywords
- Urology, smooth muscle, detrusor, matrix, nerves, subtotal cystectomy, bladder regeneration, enterocystoplasty, nephrology, Urologi, nefrologi
- pages
- 46 pages
- publisher
- Avdelningen för urologi, institutionen för kliniska vetenskaper i Lund (IKVL).
- defense location
- Föreläsningssal 3, Blocket, Universitetssjukhuset i Lund
- defense date
- 2007-09-28 09:00:00
- ISBN
- 978-91-85897-03-2
- language
- English
- LU publication?
- yes
- additional info
- H Frederiksen, T Davidsson, W Månsson and B Uvelius. 1999. Sprouting of bladder nerves into cystoplastic cecal segment in the rat. Urol. Res., vol 27 pp 476-482.H Frederiksen, R Sjuve, A Arner and B Uvelius. 2001. Regeneration of detrusor muscle after subtotal cystectomy in the rat; effects on contractile proteins and bladder mechanics. Neurourol & Urodyn, vol 20 pp 685-697.H Frederiksen, A Arner, U Malmqvist, R Sjuve and B Uvelius. 2004. Nerve induced responses and force-velocity relations of regenerated detrusor muscle after subtotal cystectomy in the rat. Neurourology and Urodynamics, vol 23 pp 159-165.Y Semerdzhiev, H Frederiksen, P Hedlund, T Davidsson, W Månsson and B Uvelius. 2006. Cystometric and in-vitro muscle studies of cystoplastic appendiceal segments in the rat. Neurourol Urodyn, vol 25 pp 259-267.H Frederiksen, T Davidsson, G Gabella and B Uvelius. 2007. Nerve distribution in rat urinary bladder after incorporation of acellular matrix graft or subtotal cystectomy. (submitted)
- id
- 16683a24-f244-4bb4-99e8-56c540eaca2c (old id 598890)
- date added to LUP
- 2016-04-04 10:34:06
- date last changed
- 2018-11-21 20:59:31
@phdthesis{16683a24-f244-4bb4-99e8-56c540eaca2c,
abstract = {{Reduced urinary bladder capacity is a clinically significant problem. The surgical methods that have been available to treat this, such as urinary diversion or surgically augmenting the bladder by incorporation of intestinal segments, all have serious drawbacks. There is a need to understand how the smooth muscle of the intestine and bladder can interact when brought into close contact surgically, and also to develop methods to reconstruct the bladder without using intestinal segments.<br/><br>
<br/><br>
The experiments on bladder reconstruction performed in this study ? regeneration after subtotal cystectomy, replacement with bowel segments and matrix grafts ? show that the bladder has a high capacity for regenerative growth. After enterocytstoplasty, nerves from the bladder grow into the intestinal segment, in which ganglionic atrophy appears.This is a possible explanation to the shift in pharmacological properties shown to occur in such segments with time, a phenomenon also found in our experiments. The cystometric findings in animals operated with enterocystoplasty suggest that the bowel segment, at least to some degree, participates in the emptying of the bladder, i.e. the intestinal muscle is functionally integrated into the bladder wall and not merely a passive part during emptying. The findings after subtotal cystectomy show that the rat bladder can produce new, contracting muscle, although with lowered maximal shortening velocity and lowered maximal force production ability compared to controls. The nerves found in the bladder developing after subtotal cystectomy represent growth and branching of pre-existing nerves. The nerves found in the small intestinal submucosa matrix grafts are a continuation of nerve trunks from the bladder reaching the grafts at the suture line. The nerve trunks and muscle bundles in the subtotally cystectomized bladders and in the matrix grafts do not fully attain the growth pattern found in normal bladders.}},
author = {{Frederiksen, Hans}},
isbn = {{978-91-85897-03-2}},
keywords = {{Urology; smooth muscle; detrusor; matrix; nerves; subtotal cystectomy; bladder regeneration; enterocystoplasty; nephrology; Urologi; nefrologi}},
language = {{eng}},
publisher = {{Avdelningen för urologi, institutionen för kliniska vetenskaper i Lund (IKVL).}},
school = {{Lund University}},
title = {{Experimental Bladder Reconstruction}},
url = {{https://lup.lub.lu.se/search/files/5569425/598892.pdf}},
year = {{2007}},
}