Related Experiment Videos
Histological and environmental changes in longstanding ileal conduits.
D J Thomas1, N M Goble, D A Gillatt
1Department of Urology, Bristol Royal Infirmary.
Journal of the Royal Society of Medicine
|September 1, 1990
Summary
Endoscopic examination of urinary diversions revealed significant mucosal changes, including villous atrophy and hyperplasia, alongside colonic-type bacterial colonization. These findings suggest potential long-term alterations in diversion anatomy and microenvironment.
Area of Science:
- Urology
- Gastroenterology
- Surgical Pathology
Background:
- Urinary diversions are surgically created conduits for urine excretion.
- Long-term surveillance of urinary diversion stomas is crucial for detecting pathological changes.
Purpose of the Study:
- To investigate the histological and cytological characteristics of the anastomosis region in long-term urinary diversions.
- To assess the microbial flora and mucin profiles within urinary conduits.
Main Methods:
- Endoscopic examination of 17 patients with urinary diversions (10-17 years post-surgery).
- Histological and cytological analysis of biopsy specimens from the anastomosis.
- Bacterial flora analysis of urine aspirated from conduits.
- Flow cytometry for cell cycle analysis and mucin histochemistry.
Main Results:
- Successful biopsies obtained in 13 cases.
- Histology showed villous atrophy, mucosal metaplasia, and crypt hyperplasia; one case had antral gland metaplasia.
- Flow cytometry confirmed hyperplasia with increased G2 and metaphase cells.
- Predominant colonic-type bacterial colonization and mucin were observed.
Conclusions:
- Long-term urinary diversions exhibit significant mucosal alterations, including metaplasia and hyperplasia.
- The presence of colonic-type bacteria and mucin suggests a shift in the conduit environment.
- These changes may have implications for the long-term health and surveillance of urinary diversion patients.