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8 CYSTOPLASTY AUGMENTATION FOR NEUROGENIC BLADDER USING SMALL INTESTINAL SUBMUCOSA
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The use of SIS has been reported before in anumber of various animals and in human subjects,but in this series the authors have used a doublepatch in 3 of the 8 individuals based on the preop-erative size of the bladder in order to achieve asufficient volume. Regardless of the size of thepatch, there was no difference in total bladder ca-pacity, maximum detrusor pressure or complianceafter the 1-year observation period. Promising re-sults have been noted before with polyglycolic acidand other materials, as well as with seeded andnonseeded scaffolds, only to discover later thatthese patches contracted, capacity diminished andpressures increased, leading to the necessity of anenteric augment. Therefore, as someone who has
Dochead: New Technology and Techniques DIS 5.2.0 DTD �
seen a multitude of long-term issues associatedwith intestinal augments, I am encouraged withthese intermediate results. I trust the authors willcontinue their meticulous followup of this cohort forseveral more years to determine if these moderate-term good results are maintained. Whether non-seeded scaffolds are a better long-term source thancell seeded constructs remains to be seen, but atleast at this juncture the technology reported hereis promising.
Stuart B. BauerDepartment of Urology
Boston Children’s Hospital
Harvard Medical School
Boston, Massachusetts
846847848 849850851852853REPLY BY AUTHORS
We will continue the careful followup of this capacity and increased pressure in the long
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cohort to determine the long-term outcomes.Although this nonseeded scaffold is easy to usein clinical practice, we also note that any kindof patch is likely to shrink, leading to reduced
term. More cases are being accumulated at ourdepartment, and we look forward to reportingthe long-term results of this technology in thefuture.
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859860JURO11353_proof � 15 May 2014 � 7:24 pm � EO: JU-13-2154
