Colonic metaplasia in the long-term follow-up of the ileal neobladder

Objective: To look for the presence of colonic metaplasia (CM), the shiftin g from sialomucins (Sls) to sulfomucins (SUs), considered as a probably pre malignant lesion in the stomach in the mucosa of the ileal neobladder (IN). Methods: 19 patients with IN were subjected to endoscopic biopsy; the samp les were analyzed by means of histochemistry with high iron diamine, a test indicated to identify Sls and SUs, Results: CM was never observed earlier than 1 year after the operation, was absent in 9/19 patients (mean follow-u p 14 months) and present in 10/19 (mean follow-up 59 months). Conclusion: T ime-dependent phenotypic changes, already described in the stomach as being premalignant, take place after constant contact with urine in the mucosa o f the IN. It is at present unclear whether they may be defined as only meta plastic or frankly preneoplastic; anyway, a careful follow-up remains indic ated in all patients with intestinal urinary diversions. Copyright (C) 2001 S. Karger AG, Basel.