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KMID : 0350519930460010345
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Journal of Catholic Medical College
1993 Volume.46 No. 1 p.345 ~ p.353
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Seromuscular Ileocystoplasty in Rats
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Abstract
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The use of isolated intestinal segments is currently the best method of augmenting bladder capacity..Bladder replacement or augmentation by conventional ileocystoplasty was associated with numerous complications, that is hyperchloremic acidosis,
hypokalemia, residual urine, urinary obstruction secondary to mucus plugs, urinary tract infections, potential upper tract deterioration, and risk of cancer.
This study was attempted to alleviate these complications by the use of reversed seromuscular segments of ilem devoid of mucosa in rats.
The experimental animals were divided into two groups ;
Group 1 ; conventional ileocystoplasty, and Group 2 ; reversed sercmuscular ileocystoplasty devoid of mucosa.
Forty six rats(group 1 ; 18 & group 2 ; 28), weighing 230-310 gm, underwent ileocystoplasty. The bladder capacity of two groups was compared and cystectomies were performed at one, two, four and eight weeks after ileocystoplasty.
Hema oxylin and eosin staining was used for histopathologic examination.
@ES The results were as follows :
@EN 1. Bladder capacity
The bladder capacity was increased postoperatively at each group(P<0.01) (group 1 ; 0.76±0.19 ml at operation-1.64±0.32 ml at sacrifice. Group 2 ; 0.77±0.18 ml at operation-1.68±0.38 ml at sacrifice).
There was no difference of increase in bladder capacity between both group.
2. Histopathologic examination 1) Gross findings Group 1 ; The outward boundaries of augmented bladder were well identified. The surface of grafted ileal mucosa in the bladder was smooth, soft and twinkling appearance.
Group 2 ; The outward boundaries of the grafted ileal segment could not be identified because of dense adhesion to other intra-abdominal viscera. The serosal surface of reversed seromuscular segment in the bladder was pale and glittering
appearance. The shrinkage of grafted ileal segment didnt occur at both group.
2) Microscopic findings Group 1 ; Transitional epithelium extended well over the intestinal mucosa through the anastomotic sith at 4 weeks & 8 weeks after ileocytoplasty.
Group 2 ; Well-developed urothelium covered the reversed seromuscular graft devoid of mucosaover the anastomotic site. This finding showed well over 4 weeks after ileocystoplasty. Grafted reversed seromuscular ileal segment showed functioning
muscle layers and de-epithelialized graft had residual intestinal mucosa.
These studies suggests that the reversed seromuscular ileocystoplasty devoid of mucosa shwed increase of bladder capacity same as conventional ileocystoplasty and canalleviate the complication related to excess mucous prduction occured at
conventional ileocystoplasty.
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KEYWORD
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