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[Long-term morphological changes in mucosa of intestinal urinary reservoir]
1Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University of Medical Sciences, Guangzhou 510120, China.
Objective:
To investigate the relationship between long-term morphological changes in the mucosa of the intestinal urinary reservoir (IUR) and postoperative complications.
Methods:
A total of 25 patients undergoing the replacement of bladder with IUR were followed up. Of these 25 patients, 15 had colonic pouch and 10 ileal pouch. Tissues of IUR were biopsied examined with microscope and transmission electron microscope.
Results:
In patients with colonic pouch, the glandular depth was (0.17 +/- 0.04) mm and microvillous height (0.35 +/- 0.05) micron, which were significantly lower than those (0.42 +/- 0.04) micron and (0.69 +/- 0.08) mm in the control group. In those with ileal pouch, the microvillous height was (0.70 +/- 0.14) mm, (0.54 +/- 0.10) mm and (1.99 +/- 0.14) mm in the short-term group, long-term group and control group, respectively. As compared with the control group, mucous atrophy in these patients was more severe. Tight junctions of the epithelium in both kinds of pouches were well preserved even in the long-term cases. No remarkable malignant changes were found in the IUR mucosa in all the patients. Meanwhile, no special morphological changes were seen in the patients with metabolic acidosis or pouch calculus.
Conclusions:
IUR mucosa has some morphological "adaptive" changes after the operation. Intestinal segments are ideal bladder substitutions.