Treatment of the
neurogenic bladder in canine models of
spinal cord injury presents challenges in ensuring bladder drainage. While
vesicostomy is routine for humans, the procedure is not common in canines. Our study of bladder reinnervation involved transection of the nerve roots that mediate bladder contraction in 34 canines. An abdominal
vesicostomy was created by fixing the everted mucosa to the skin incision. After
euthanasia, we assessed the contractility of in vitro bladder muscle strips in response to
muscarinic receptor stimulation. There were a total of 11 complications in 9 of the 34 animals. In two animals, the
vesicostomy narrowed such that it could not be catheterized and in two other animals the
vesicostomy closed to between 5 and 10 mm diameter. Another animal removed the stitches prior to complete healing, requiring further
surgical procedures. In fi ve animals, partial
prolapse of the bladder through the
vesicostomy required surgical repair, and in one animal the bladder became infected and required
antibiotic treatment. In the few animals in which irritation resulted from the constant contact of urine with the skin, daily topical application of
petrolatum ointment alleviated this symptom. Gross inspection of the bladder at
euthanasia and in vitro contractility of bladder muscle strips from these animals revealed no evidence of changes associated with bladder
hypertrophy. This study demonstrated that permanent cutaneous
vesicostomy is an optimal refinement method for management of the
neurogenic bladder in canines. The procedure avoids the distress as well as potential bladder
hypertrophy induced by multiple daily interventions to empty the bladder by either catheterization or manual compression.