Early histological changes of ileal mucosa after augmentation cystoplasty

Segments of bowel are used routinely for transplantation in various patholo gical conditions such as contracted bladders or poorly compliant neuropathi c bladders. However, little is known how these intestinal segments adopt to a toxic environment caused by urine. Therefore, the present study was perf ormed to determine early histological changes of ileal mucosa after augment ation cystoplasty. Seven patients with augmentation cystoplasty underwent r andom cold-cup biopsies of ileal segments after a mean period of 14.4 month s after cystoplasty and morphological changes were evaluated using light mi croscopy and transmission and scanning electron microscopy. Most pronounced features were varying degrees of villous atrophy, increased numbers of Pan eth and goblet cells. Severity of atrophic villous changes were not related to the length of the interval between surgery and endoscopic biopsy. These findings may be explained as adaptations of bowel tissue to counteract nox ious effects of urine and to maintain its epithelial function in the bladde r.