An autotransplantation of a pedical intestinal smooth muscle graft to the detrusor of the bladder was designed as an imitative operative procedure for the treatment of the neurogenic bladder.Neurogenie bladder models were made on 15 mongrel dogs,aged from 3-6 months,weight 3-7 kg,by the way of peripheral denervation.A free ileal segment about 20cm in length with intact mesentery but with its mucosa stripped off was sutured to the bladder wall where the adventitia had been removed.The micturation disorder of the dogs having improved within 3 months was indicated by increasing voiding volume and prolonging the holding time.Histological study revealed hematoma and inflammation between the seromuscular graft and detrusor muscle in the first 10 days;granulation tissue,small blood vessels,and fibroblast infiltration followed;and connective tissue increased between the two layers of smooth muscles one month after the graft.With Bieschowsky stain,a small amount of nerve fiber can be observed to be growing toward the detrusor muscle after three months.The capacity of the bladder increased and the contraction curves of the detrusor muscle became even nearly normal.The graft's electric actions was recorded by electromyogram as the detrusor muscle contracted.The results of this experiment reveals:(1) the nerve fibers of the pedicle graft can grow into the detrusor muscle,(2)the intestinal smooth mrscle is similar to the detrusor muscle and its potential action can be transmitted to the detrusor muscle through the connective tissue between the two layers.%去粘膜肠管平滑肌加强膀胱逼尿肌的手术是治疗小儿无反射性神经性膀胱的一种新方法.本文通过动物实验对手术机理进行了探讨.结果表明;移植后肠平滑肌生存良好,逼尿肌与肠平滑肌之间由结缔组织相连接.两层平滑肌间结缔组织中有神经组织生长,可见到穿行的神经纤维.因此,术后疗效可能和膀胱逼尿肌重获神经支配有关.
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