To the content
3 . 2021

Experimental artificial bladder modeling using the rectus abdominis muscle

Abstract

Background. Reconstructive bladder surgery is one of the most difficult issues in urological surgery practice. In addition to classical techniques of orthotopic bladder substitution, the search for alternative methods in reconstructive surgery still continues.

The main aim of this study is to develop a working artificial bladder model using a flap from the rectus abdominis muscle.

Material and methods. We selected the swine as a suitable biological model for our experiment because of its anatomical similarity to humans. To facilitate the surgical technique, we choose a muscle flap from the rectus abdominis muscle. This choice was justified by the feasibility of translocation of a flap on the vascular pedicle without the need of microsurgical technique. Results. The experiment demonstrates the feasibility of an alternative bladder reconstruction technique from the rectus abdominis muscle flap.

Conclusion. Our experiment demonstrated the feasibility of an alternative bladder reconstruction technique involving formation of a "neobladder" from the rectus abdominis muscle flap.

Keywords:bladder reconstruction, neobladder, radical cystectomy, muscle flap, rectus abdominis

Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Adamyan R.T., Khachatryan A.A., Tevosyan A.A., Arakelyan G.H., Dydykin S.S., Kovaleva D.R., Dzhuganova V.O. Experimental artificial bladder modeling using the rectus abdominis muscle. Clinical and Experimental Surgery. Petrovsky Journal. 2021; 9 (3): 37-43. DOI: https://doi.org/10.33029/2308-1198-2021-9-3-37-43 (in Russian)

References

1.    Stein J., Lieskovsky G., Cote R., et al. Radical cystectomy in the treatment of invasive bladder cancer: long-term results in 1,054 patients. J Clin Oncol. 2001; 19 (3): 666-75. DOI: https://doi.org/10.1200/jco.2001.19.3.666

2.    Kulchavenya E. Best practice in the diagnosis and management of urogenital tuberculosis. Ther Adv Urol. 2013; 5 (3): 143-51. DOI: https://doi.org/10.1177/1756287213476128

3.    Ravi R., Dewan A., Pandey K. Transverse colon conduit urinary diversion in patients treated with very high dose pelvic irradiation. Br J Urol. 1994; 73 (1): 51-4. DOI: https://doi.org/10.1111/j.1464-410x.1994.tb07455.x

4.    Cox A., Golda N., Nadeau G., et al. CUA guideline: diagnosis and treatment of interstitial cystitis/ bladder pain syndrome. Can Urol Assoc J. 2016; 10 (5-6): 136. DOI: https://doi.org/10.5489/cuaj.3786

5.    Loran O.B., Veliev E.I., Seregin I.V., Seregin A.V., Luk’yanov I.V. The complications of radical cystectomy with orthotopic urinary diversion. Annaly khirurgii [Annals of Surgery]. 2017; 22 (2): 97-103. DOI: https://doi.org/10.18821/1560-9502-2017-22-2-97-103  (in Russian)

6.    Swindle M., Makin A., Herron A., Clubb F., Frazier K. Swine as models in biomedical research and toxicology testing. Vet Pathol. 2011; 49 (2): 344-56. DOI: https://doi.org/10.1177/0300985811402846

7.    Vachnadze D., Breshenkov D., Dydykin S. Anesthesia in swines as a model in biomedical and biotechnological studies. Voprosy rekonstruktivnoy i plas-ticheskoy khirurgii [Problems of Reconstructive and Plastic Surgery]. 2016; 4 (59): 37-46. DOI: https://doi.org/10.17223/1814147/59/05  (in Russian)

8.    Gelb A., Morriss W., Johnson W., Merry A. World Health Organization-World Federation of Societies of An-aesthesiologists (WHO-WFSA) International Standards for a Safe Practice of Anesthesia. Can J Anesth (Journal Canadien d’Anesthesie). 2018; 65 (6): 698-708. DOI: https://doi.org/10.1007/s12630-018-1111-5

9.    Schndrer S., Amend B., Stenzl A., Rausch S. Reconstructive surgery of the urinary bladder. Ak-tuelle Urol. 2017; 48 (6): 561-8. DOI: https://doi.org/10.1055/s-0043-104508

10.    Qu L.G., Lawrentschuk N. Orthotopic neobladder reconstruction: patient selection and perspectives. Res Rep Urol. 2019; 11: 333-41. DOI: https://doi.org/10.2147/RRU.S181473

11.    Atala A., Bauer S.B., Soker S., Yoo J.J., Retik A.B. Tissue-engineered autologous bladders for patients needing cystoplasty. Lancet. 2006; 367 (9518): 1241-6. DOI: https://doi.org/10.1016/S0140-6736(06)68438-9 PMID: 16631879.

12.    Perovic S.V., Djordjevic M.L., Kekic Z.K., Vukadi-novic V.M. Bladder autoaugmentation with rectus muscle backing. J Urol. 2002; 168 (4 Pt 2): 1877-80. DOI: https://doi.org/10.1097/01.ju.0000030041.09225.41 PMID: 12352380.

13.    Zhang J.Q., Zhang J.M., Liang W.Q., Ji C.Y., Chen Y.H. Lengthening the pedicle of the rectus abdominis myocutaneous flap for repair of upper chest and neck defects. Ann R Coll Surg Engl. 2017; 99 (6): 464-71. DOI: https://doi.org/10.1308/rcsann.2017.0055

14.    Ninkovic M., Stenzl A., Schwabegger A., Bartsch G., Prosser R., Ninkovic M. Free neurovascular transfer of latissimus dorsi muscle for the treatment of bladder acontractility: II. Clinical results. J Urol. 2003; 169 (4): 1379-83. DOI: https://doi.org/10.1097/01.ju.0000055257.87004.ba  PMID: 12629366.

15.    Zhang Y.H., Shao Q.A., Wang J.M. Enveloping the bladder with displacement of flap of the rectus abdominis muscle for the treatment of neurogenic bladder. J Urol. 1990; 144 (5): 1194-5. PMID: 2146404.

16.    Russell R.C., Pribaz J., Zook E.G., Leighton W.D., Eriksson E., Smith C.J. Functional evaluation of latissimus dorsi donor site. Plast Reconstr Surg. 1986; 78 (3): 336-44. DOI: https://doi.org/10.1097/00006534-198609000-00009 PMID: 3737758.

All articles in our journal are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0 license)

CHIEF EDITOR
CHIEF EDITOR
Sergey L. Dzemeshkevich
MD, Professor (Moscow, Russia)

Journals of «GEOTAR-Media»