[Laparoscopic vesical autoaugmentation: an animal model in rabbits (Oryctolagus cuniculus)]. / Autoaumento vesical por laparoscopia. Modelo experimental en conejos (Oryctolagus cuniculus).

INTRODUCTION: Small contracted bladder remains a challenge in clinical urological practice and treatment options are not always effective. Urothelium sparing surgical techniques represent a reasonable therapeutical option. We aimed to evaluate the feasibility of a rabbit model (Oryctolagus cuniculus) in the teaching and training setting for laparoscopic vesical autoaugmentation. METHODS: Transperitoneal laparoscopic bladder autoaugmentation was performed in five New Zealand male rabbits (Oryctolagus cuniculus). A three port technique was used for all cases. Circumferential detrusorectomy was performed with vascular pedicles sparing, subsequently submucosal detailed blunt dissection allowed the creation of a bladder diverticulum which was verified intraoperatively. Eye-ball cystometry was performed preoperatively and postoperatively to verify bladder capacity variations. Postoperatively cystometry was done immediately after the procedure and 7 and 15 days postoperatively. Statistical analysis was performed with T-student model. A p-value < 0.05 was considered of significance for the analysis. Surgical procedure and perioperative animal care was minutely precised according to the Guidelines of the Institute of Laboratory Animal Resources, Commission on Life Sciences, National Research Council. RESULTS: Five New Zealand male rabbits (Oryctolagus cuniculus) were surgically treated as described. Median operative time was 68.8 minutes (range 44 -120). Median preoperatory bladder capacity for the series was 25.8 cc (7-52). Median postoperative bladder capacity was diminished in 33% immediately after the operation. Then, bladder capacity augmented 72% and 52% for 7th and 15th postoperative days, respectively. Percentage variation in bladder capacity is statistically significant. Two operative complications (mucosal tear) were reported. A postoperatory abscess was observed in one animal. CONCLUSION: The rabbit (Oryctolagus cuniculus) model for the laparoscopic bladder autoaugmentation is feasible for teaching, training and research. Bigger series and longer follow-up should be addressed.

[Primary signet ring cell bladder adenocarcinoma. Case report with a multidisciplinary therapeutical approach]. / Adenocarcinoma en células en anillo de sello primario de vejiga. Presentación de un caso clínico con tratamiento multidisciplinario.

INTRODUCTION: Bladder carcinoma is the second most frequent genitourinary tumor. Adenocarcinoma accounts for up to 0.5 to 2% of bladder carcinoma types. The pathology states the bladder adenocarcinomas are mucous secreting lesions with glandular, colloid or signet ring cell patterns. Even the important advances reached in the field of bladder carcinoma, yet less frequent lesions as bladder adenocarcinoma do not have a standarized treatment protocol. METHODS: Case report of a patient with primary signet ring cell bladder adenocarcinoma with a therapeutical multidisciplinary approach. Literature review. RESULTS: Patient's outcome and follow up, with regard of therapeutical implications based on pathological findings. CONCLUSIONS: Bladder adenocarcionoma is a rare oncological entity. Treatment protocols for these particular tumors are lacking. Multidisciplinary approach represents the best therapeutical intervention.