Evaluation of Vascularized vs. Non-Vascularized Mucosa-Stripped Jejunal Grafts in Canine Bladder Augmentation

Bladder augmentation remains a surgical challenge, particularly in maintaining graft viability and achieving functional bladder regeneration. Although demucosalized intestinal grafts have shown regenerative potential, the use of non-vascularized demucosalized jejunal free grafts has not been previously investigated. This study compared vascularized versus non-vascularized demucosalized jejunal grafts for bladder augmentation in dogs and assessed whether omental pedicle flap coverage promotes regeneration in the non-vascularized demucosalized free grafts. Eighteen healthy adult male dogs were randomly allocated into two equal groups (n=9). Group I underwent bladder augmentation using a vascularized demucosalized jejunal flap (VDJF), while Group II received a non-vascularized demucosalized jejunal free graft (NVDJG), wrapped with an omental pedicle flap. Clinical evaluation, laparoscopy, and histopathological examinations were performed at 15, 30, and 60 days postoperatively. All animals recovered without major complications. Laparoscopic examination showed successful graft integration, progressive healing, and no evidence of urine leakage, graft necrosis, or wound dehiscence in either group. Histopathological findings demonstrated progressive bladder wall regeneration in both groups, characterized by angiogenesis, granulation tissue formation, urothelial regeneration, smooth muscle development, and extracellular matrix remodeling. Most histological parameters didn’t differ significantly between groups (P < 0.05); although the group Ⅰ showed slightly more advanced tissue organization, especially in fibrous connective tissue maturation, it was significantly greater at 60 days. Both techniques achieved satisfactory structural regeneration by the end of the study. These findings suggest that both vascularized and omentum-supported non-vascularized demucosalized jejunal grafts are effective for bladder augmentation in dogs. Omental coverage appears to enhance the survival and regenerative potential of free jejunal grafts, offering a practical alternative when preservation of the mesenteric vascular pedicle is not feasible.