Paper Information

Title: 

OPEN SURGICAL PRODUCTION OF AN ANIMAL MODEL OF VESICOURETERAL REFLUX (VUR) IN THE DOG

Type: PAPER
Author(s): MARJANI M.*,KAJBAFZADEH A.M.,BAKHTIARI J.
 
 *
 
Name of Seminar: CONGREH ANJOMAN UROLOGY IRAN
Type of Seminar:  CONGRESS
Sponsor:  ANJOMAN OROLOGY
Date:  2005Volume 8
 
 
Abstract: 

INTRODUCTION: REFLUX OF URINE FROM BLADDER INTO THE URETERS AND THE UPPER URINARY SYSTEM IS 0.5-18.5% IN CHILDREN, RATING UPTO 24-50 IN THOSE AFFECTED BY RECURRENT URINARY TRACT INFECTIONS (UTI). VARIOUS PHARMACOLOGIC OR SURGICAL METHODS ARE USED IN THE TREATMENT OF VESICOURETERAL REFLUX (VUR), THE NEWEST OF WHICH IS SUBURETERIC INJECTION OF BIOCOMPATIBLE MATERIALS AT THE URETEROVESICAL JUNCTION (UVJ). BECAUSE THE NEW MATERIALS AND SURGICAL TECHNIQUES ARE NOT TESTABLE ON HUMAN PATIENTS, ESPECIALLY THE PEDIATRIC GROUP, DUE TO LEGAL AND ETHICAL ISSUES, THESE SHOULD BE FIRST INVESTIGATED ON ANIMALS, THEN ON HUMANS FOLLOWING ELIMINATION OF THE UNWANTED CASES AND OBTAINING THE DESIRED RESULTS.
METHODS: IN THIS STUDY, 25 MIXED-BRED DOGS, WEIGHING ROUGHLY 5-25 KG EACH, AGED 3-6 MONTHS AND IRRESPECTIVE OF GENDER, WERE USED TO CAUSE VESICOURETERAL REFLUX. REFLUX WAS PRODUCED UNILATERALLY IN 6 DOGS AND BILATERALLY IN 9 OF THEM. PRIOR TO OPERATION, ALL THE CASES WERE ASSESSED FOR CONGENITAL OR ACQUIRED URINARY REFLUX WITH INSTILLATION OF RADIO-OPAQUE MATERIAL INTO THE BLADDER AND CYSTOGRAPHY. NON-REFLUX CONFIRMED, THE MODEL WAS PRODUCED WITH OPEN SURGICAL INCISION ON URETERAL ROOF AND SUTURING OF THE URETER TO THE BLADDER WALL, BILATERALLY. 3/0 SUTURES WITH ROUND, NON-CUTTING NEEDLES, AND SEPARATE-TYPE STITCHES WERE USED.
RESULTS: WITH THIS INCISION AND ITS FIXATION WITH SUTURE, REFLUX WAS POSSIBLE FROM THE BLADDER INTO THE URETER. ONE WEEK LATER, WITH REDUCED INFLAMMATION AND INCREASED HEALING OF THE SITE, REPEAT CYSTOGRAPHY WITH RADIOCONTRAST MATERIAL WAS CARRIED OUT AND A MILD, MODERATE OR SEVERE REFLUX, UNILATERALLY OR BILATERALLY, WAS CONFIRMED.
CONCLUSION: FOR THE FIRST TIME IN THE COUNTRY, PRODUCTION OF THE ANIMAL MODEL FOR VESICOURETERAL REFLUX HAS BECOME POSSIBLE, TO BE USED IN RESEARCH CENTERS FOCUSED ON NEW TREATMENT MODALITIES THEREOF. IT IS EVEN POSSIBLE TO INDUCE A DESIRED DEGREE OF REFLUX ON EITHER SIDE. IN THE CURRENT INVESTIGATION, UNLIKE ALL PREVIOUS ONES, THE DETAILS OF THE WORK ARE PRESENTED WITH NUMEROUS PHOTOGRAPHS AND VIDEOS.

 
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