MUCOSAL MORPHOLOGICAL-CHANGES IN THE ILEAL NEOBLADDER

Objective To determine the ultrastructural changes in the mucosa of in testinal segments used as a neobladder. Materials and methods Biopsy s pecimens from the ileal neobladders of eight men (mean age 62 years, r ange 52-68) who had undergone radical cystectomy were assessed by ligh t and electron microscopy from 1 month to 5 years after operation. The morphology was compared with that in control specimens obtained from three patients of similar age during construction of an ileal neobladd er after radical cystectomy. Results Light microscopy showed shorter m ucosal villi and fewer goblet cells. Marked oedema was found in all il eal neobladder walls. Electron microscopy revealed fewer and shorter m icrovilli and fewer filamentous core rootlets; cell borders were irreg ular, there were few senile cells in the tip of the villi and more des mosomes, Conclusions The absorptive and secretory function of the inte stinal mucosa was probably decreased; the oedema of transferred ileal mucosa seemed to be associated with an inflammatory cell reaction, The cellular dynamics of the mucosa of the ileal neobladder changed crith time, thus the ileal mucosa in the substitute bladder apparently adap ted well to the new environment, i.e. urine retention, and neobladder expansion and contraction.