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KMID : 0350519940470010457
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Journal of Catholic Medical College
1994 Volume.47 No. 1 p.457 ~ p.464
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Augmentation Cystoplasty Using De-epithelialized Ileum in Rats
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Abstract
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With the increased use of augmentation intestinocystoplasty, numerous complications have been recognized. Most of them are related to the bowel mucosa. These problems include mucus production within the new augmented bladder, electrolyte
reabsorption
leading to metabolic disturbances and the possibility of later malignant change in the mucosa. This study was attempted to investigate the effect of deepithelialized ileocystoplasty in rats.
The experimental rats, weighing 210-330 grams, were divided into two groups: group I (16 rats) ; conventional ileocystoplasty, group ii (20 rats) ; ilecoystoplasty devoid of mucosa. 24-hours urine was collected for each rat weekly and then the
amount of
lyophilized dry mucus in urine was measured. The bladder capacity of two groups was also compared. And cystectomies were performed at one, two four, and eight weeks after ileocystoplasty.
Histopathologic examination of ileocystoplasty specimens was done by light microscope after H-E staining, PAS reaction for goblet cell stain and Masson-trichrome staining for detecting fibrosis of ileal patch.
@ES The results were as follows:
@EN 1. The amount of urinary lycphilized dry mucus in the group I was increased at postoperative 4 weeks and decreased at 8 weeks. In the group ii, the amount of lyophilized dry mucus significantly decreased at postoperative 4 weeks and 8 weeks
when
compared with the group I (P<0.01).
2. The bladder capacity was increased postoperatively in both groups(P<0.01). There was no differences of increase between both groups.
3. Histopathologic examination
On gross examination, the outward boundaries of augumented bladder were well identified in both groups. Graft contraction of augumented segment occurred in 20% of them in group ii.
On microscopic examination, transitional epithelium extended well over the ileal surface at 4 weeks postoperatively in both groups. Fibrosis was not found in group I and fibrosis of grafted ileal segment was found in 20% of group ii.
These results suggest that ileocystoplasty devoid of ileal mucosa showed significantly decreased mucus production compared to conventional ileocystoplasty and also showed increase of bladder capacity as conventional ileocystoplasty.
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