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Researchers advance child bladder reconstruction

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Employing a variety of the most sophisticated experimental techniques and procedures, researchers have advanced treatments for children in need of bladder reconstruction.

A new study, presented during the 106th Annual Scientific Meeting of the American Urological Association (AUA), outlines a new technique using a demucosalised stomach flap as an autograft supplement in gastrocystoplasty.

A stomach flap is commonly used as an autograft supplement in gastrocystoplasty for pediatric bladder reconstruction. However, two main problems arise when using this tissue: the stomach mucosa causes many complications when an entire stomach flap is used; and the stomach graft contracts if a demucosalized stomach flap is used. Researchers investigated the use of a demucosalized stomach flap covered with bladder cell-seeded small intestinal submucosa and whether botulinum toxin A, used for treating severe bladder spasticity, could be used to prevent contraction of the flap.

The study, led by researchers at the University of Oklahoma Science Health Center, was completed in 10 adult beagle dogs weighing 10 -12 Kg. All of the dogs survived and their gastric grafts were all viable with a good blood supply. All the stomach flap grafts contracted 10 weeks after surgery. However, those that were treated with bladder cell-seeded SIS and Botox A injection contracted significantly less, demonstrating a potential clinical use in bladder reconstruction via gastrocytoplasty.

“Being able to use a patient’s own cells to regenerate and re-grow tissue to treat disease is truly a remarkable step forward in medicine,” said session moderator Anthony Atala, MD, an AUA spokesperson and recognised world leader in the area of tissue regeneration. “These new techniques help minimize risks of rejection and the need for immunosuppressants, while providing a return to normal control and function.”

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