Evaluation of a Bladder Advancement Extension Graft Technique

A bladder advancement extension technique was developed to provide a reliable method for creating an extra length of bladder in continuity, so that Boari flap and psoas hitch procedures, with or without the extension grafts, would reach sufficiently high routinely to permit these procedures to become the preferred practical options for accommodating significant proximal ureteric deficiencies or for replacing the whole of the ureter. In addition, an omentally supported bladder graft was established separately for use in a "retrieval" procedure should extension graft stenosis develop subsequently. Of 10 dogs studied for 6 months, 2 required "retrieval" pedicled island patch grafts for stenoses at extension graft/upper ureteric junctions. Healthy urothelium with muscle in the walls was seen in grafts resting on their supporting omental beds. At the time of sacrificing, none of the operated upper tracts was obstructed.