Given its rich lymphatic supply, omentum may have contributed to absorption of residual hematoma or urine extravasation and thus reduced the risk of infection. Furthermore, omentum encasing both bladder neck and Silastic may have prevented rigid scar formation. At cystoscopy, Young-Dees tubes wrapped with omentum seemed particularly pliable. In this respect, one of the original goals to prevent kinking of the Young-Dees tube was likely achieved. Young-Dees tube length was not noticeably enhanced, however.
Infection is also likely to have been an important risk factor for erosion.
In the analysis of their own series, the London group found simultaneous bladder augmentation to be a statistically significant risk factor, in the patients with triply folded silastic. These erosions tended to occur early. Seventy-five percent of the Indianapolis patients undergoing simultaneous bladder augmentation suffered erosion, although the timing of erosion was unclear. We hypothesize that infection of the Silastic sheath was a contributing factor to erosion in these patients. The one well documented iatrogenic cause was erosion following internal urethrotomy in the London series.