Bladder repair following iatrogenic cystotomy in irradiated small capacity bladders

Chee, J Y; Durai, Pradeep; Wu, Fiona Mei Wen; Tiong, Ho Yee

doi:10.11622/smedj.2015052

Cited by 5 publications

(6 citation statements)

References 12 publications

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“…Since the outcome of interest in this review was the result of pericardial grafts in reconstructive urologic surgeries, we also entered case reports in our review. Seven hundred fifteen patients underwent surgical reconstruction using pericardial grafts and had completed follow-up evaluations; 8 of these patients were published as case reports [8,10,11,31,37,40,47,48]. In addition, urologic reconstructive surgeries using pericardial grafts were performed on 139 animals comprising 45 rats [27,[54][55][56], 57 dogs [52,53,57,58], 31 rabbits [24,25,51], and 6 pigs [23].…”

Section: Overall Studiesmentioning

confidence: 99%

“…Another included a female with urinary incontinence caused by urethral diverticulum, treated via urethral reconstruction using a BP graft [37]. Elsewhere, bladder wall reconstruction using BP grafts was successfully performed in a female with an enterovesical fistula [11], and in a male with an iatrogenic bladder defect caused by irradiation [8]. There was a single successful report of kidney reconstruction using a BP graft, during which BP was successfully employed for the closure of a renal capsule following a partial nephrectomy [48].…”

Section: Human Studiesmentioning

confidence: 99%

“…After treatment in glutaraldehyde, BP turns into a strong, easy-to-handle, durable, and low antigenic graft. Nevertheless, it may have a high rejection rate and adhesion to surrounding tissues, be more allergic, and be associated with calculi formation in patients undergoing urologic or vascular surgeries [8,61]. In contrast, BP has been demonstrated to be associated with no evidence of calcification, infection, thromboembolic events, or failure in pediatrics undergoing cardiac surgeries [62,63].…”

Section: Pericardial Tissue Features and Feasibilitymentioning

confidence: 99%

“…The pericardium has been utilized in animal models of bladder reconstruction, and approximately 83% of the operations were successful [23-25, 52, 56-58]. Only 2 patients underwent bladder reconstruction using treated BP, during which enterovesical fistulae and defects of the bladder wall in a post-irradiated pelvis were repaired [8,11]. Although the success rate has been relatively good, short follow-up is the main limitation in the evaluation of these procedures.…”

Section: Bladder Surgeriesmentioning

confidence: 99%

“…A variety of grafts including skin, bladder, colon, and buccal mucosa have been utilized in reconstructive urologic surgeries [4][5][6]. More recently, some other tissues such as amniotic membranes [7] and pericardial tissues have been used in reconstructive urologic surgeries [8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

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Pericardium in Reconstructive Urologic Surgeries: A Systematic Review and Meta-Analysis

Hosseini

et al. 2018

Urol Int

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Introduction: The use of pericardium has been expanded into different surgical modalities; however, there are scarce data regarding the feasibility of the pericardium in reconstructive urologic surgeries. We systematically reviewed the literature on the effectiveness of the pericardial tissue for reconstructive urologic surgeries. Materials and Methods: PubMed and Scopus were searched online for evidence on the use of the pericardium in urologic surgeries. Through the methodology recommended by the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines, 38 of 4,071 studies were identified. Results: A total of 715 patients and 139 animals underwent reconstructive urologic surgeries using the pericardium. Bladder, urethral, and renal reconstructions were successful in 100% of the human cases. The rates of dissatisfaction, glans hypoesthesia, and penile shortening were comparable between the pericardial graft surgeries and the other operations during penile straightening, but there was a trend among the patients with pericardial grafts toward having a more penile curvature at follow-up (risk ratio [RR] 2.03, 95% CI 0.90–4.61, p = 0.09; I² = 0%). Among the animal studies, there were 4 reports of penile reconstruction, 7 studies of bladder reconstruction, and 1 study of urethroplasty. Bladder reconstruction and urethroplasty were successful in 83 and 20% of the animals, respectively. The pooled result of the stimulated intracorporeal pressure 5 V significantly favored pericardial grafts during penile reconstruction (RR 2.61, 95% CI 1.26–3.97, p = 0.0002; I² = 0%). Conclusions: Our systematic review demonstrates the feasibility of the pericardium, regardless of its type, in urologic surgeries. It, however, seems that urethral substitution needs further investigation. Given the lower cost, easier handling, and less immunogenicity of the pericardium, further studies are required to examine its pros and cons.

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