Cystoplasty: tubularisation or detubularisation?

Previous studies on substitution or augmentation cystoplasty have highlighted the profusion of surgical techniques available, but there is disagreement as to which is the best. We established an animal model to compare various types of cystoplasties, tubularised and detubularised, using ileum and caecum. Detubularisation did not abolish intrinsic bowel contractions but delayed their onset. No differences were noted in the frequency and amplitude of such contractions after detubularisation or between large and small bowel cystoplasties. Although intravenous urography did not demonstrate any abnormality in upper tract anatomy, a significant number of animals had some functional disturbance of the kidney after cystoplasty demonstrable on isotope renography, irrespective of the surgical technique. It may be possible to prevent these contractions with their associated harmful effects by preventing the bladder volume from building up excessively.