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Tumors in bladder remnant after augmentation enterocystoplasty
J W Barrington1, S Fulford, D Griffiths
1Department of Urology, University Hospital of Wales, Heath Park, Cardiff, South Glamorgan, United Kingdom.
The Journal of Urology
|February 1, 1997
Summary
Tumors after ileocystoplasty likely originate from the patient's own urothelium, not the implanted bowel tissue. This may be linked to increased urinary nitrosamines, suggesting a need for further investigation into bladder cancer risk factors.
Area of Science:
- Urology
- Oncology
- Gastroenterology
Background:
- Augmentation enterocystoplasty is a surgical procedure to enlarge the bladder using intestinal segments.
- Tumors developing after this procedure raise questions about their tissue of origin.
Observation:
- A retrospective review of 4 tumors post-clam ileocystoplasty was conducted.
- Tumors were identified as adenocarcinoma, predominantly on the bladder side of the anastomosis.
Findings:
- Histological analysis revealed urothelial metaplasia and dysplasia with intestinal features.
- These changes were observed overlying the detrusor muscle and, in one case, in the renal pelvis.
- The implanted bowel mucosa showed inflammation but no neoplastic changes.
Implications:
- The findings suggest that tumors arise from the patient's native urothelium, not the bowel segment.
- Elevated urinary nitrosamines are hypothesized as a potential contributing factor.
- Further research is warranted to understand the carcinogenesis of urothelium in this context.