Is it possible to use the rectus abdominis neo-sphincter as a continence mechanism for urinary catheterizable channels? A histologic and histochemical evaluation in an experimental study in rabbits

Is it possible to use the rectus abdominis neo-sphincter as a continence mechanism for urinary catheterizable channels? A histologic and histochemical evaluation in an experimental study in rabbits

Author Damazio, Eulalio Autor UNIFESP Google Scholar
Rondon, Atila Autor UNIFESP Google Scholar
Bacelar, Herick Autor UNIFESP Google Scholar
Quitzan, Juliana Autor UNIFESP Google Scholar
Schmidt, Beny Autor UNIFESP Google Scholar
Ortiz, Valdemar Autor UNIFESP Google Scholar
Macedo, Antonio Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Objective: To evaluate in a rabbit experimental model a mechanism of continence of catheterizable urinary conduits (CUC), focusing on the behavior of intersected rectal muscle fibers in relation to the channel by histological and histochemical analysis, and secondarily to register conduit continence rates from clinical and urodynamic data.Materials and methods: 12 rabbits were submitted to construction of a CUC from two abdominal skin flaps and divided into two groups: 8 with a urinary neo-sphincter created according to Yachia and 4 controls. We registered clinical outcome, urodynamic studies and microscopic analysis of CUC on the surface of the conduit, which was in direct contact with the mechanism of continence. We took muscle samples from the mechanisms of continence and performed histochemical evaluation by enzymatic reactions.Results: Histological evaluation of the CUC showed no difference between groups. Histology and immunohistochemistry of the muscle fibers showed that areas of necrosis, cell atrophy and motor neuron injury from the first eight weeks recovered by the end of 16th week. Conduit complications occurred in 4 animals (33%). the average detrusor leakage point pressure through the conduit was 90 cm H2O versus 39 cm H2O through the urethra.Conclusion: the mechanism of continence did not promote ischemic stress on the conduit, was able to promote high pressure resistance and showed good recovery of intersected muscle fibers, after an initial slight atrophy, suggesting good durability of the neo-sphincter. (C) 2013 Journal of Pediatric Urology Company. Published by Elsevier B.V. All rights reserved.
Keywords Urinary reservoirs
Surgical stomas
Postoperative complications
Urinary catheterization
Language English
Date 2013-12-01
Published in Journal of Pediatric Urology. Oxford: Elsevier B.V., v. 9, n. 6, p. 919-926, 2013.
ISSN 1477-5131 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 919-926
Origin http://dx.doi.org/10.1016/j.jpurol.2012.12.019
Access rights Closed access
Type Article
Web of Science ID WOS:000327254400048
URI http://repositorio.unifesp.br/handle/11600/37041

Show full item record




File

File Size Format View

There are no files associated with this item.

This item appears in the following Collection(s)

Search


Browse

Statistics

My Account