Bowel segments are used either in a tubular or detubular configuration in bladder augmentation and substitutions. The majority of urologists agree that detubularized segmens give better clinical results, but detailed studies were not investigated
in
animals.
The present study compared the contractile response of autonomic agonists including carbachol, isoproterenol, α,β-methylene ATP on detubularized and tubularized cystoplastic ileal segments. In addition, histological examinations of cystoplastic
ileal
segments were performed.
Five rats underwent Sham operation as control and eight rats underwent detubularized ileocystoplasty and seven rats u0nderwent tubularized ileocystoplasty. Analysis was done six weeks after surgery.
The contractile responses of detubularized cystoplasty ileum to carbachol, α,β-methylene ATP were significantly increased when compared to the responses of tubularized ileum and control ileum. The relaxation responses of detubularized
cystoplasty
ileum to isoproterenol were significantly higher than control ileum. However, in tubularized ileum, the responses to carbachol, α,β-methylene ATP, isoproterenol were similar for control ileum. The responses of detubularized cystopalsty ileum to
carbachol, α,β-methylene ATP were significantly different from control bladder, but detubularized cystoplasty ileum showed responses that resemble control bladder more closely when compared to the responses of tubularized ileum.
The histological examination showed urothelialization of cystoplastic ileum with transitional epithelium extending over and covering the junction margin of the cystoplastic ileum. These results suggest detubularized ileocystoplasty induced closer
pharmacological changes in the ileal segment towards the bladder than tubularized ileocystoplasty and so we can expect detubularized ileocystoplasty gives better clinical outcome.
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