FURTHER OBSERVATIONS ON HISTOLOGICAL-CHANGES AT THE URETEROILEAL JUNCTION IN ILEAL CONDUITS

Seventy-two ureteroileal anastomoses taken from ileal conduits removed from 62 patients were examined histologically to characterize the ran ge of mucosal and stromal changes at these sites. All 72 demonstrated variable amounts of subepithelial chronic inflammation and fibrosis. O ther histological features included: cystic spaces lined by transition al epithelium (N = 29; 40%; average diameter 1.2 mm); cystic spaces li ned by mixed intestinal/transitional epithelium (N = 5; 7%; average di ameter 0.77 mm); and cystically dilated intestinal glands (N = 21; 29% ; average diameter 0.24 mm). The latter were associated with overgrowt h by transitional epithelium, which had prevented mucus drainage. Twen ty-one (29%) had mucus pools with no epithelial lining (average diamet er 1.2 mm), and polypoidal protrusions into the lumen of the anastomos is were found containing mucus pools (N = 4; 6%; average diameter 1.4 mm), transitional-lined cysts (N = 5; 7%; average diameter 2.2 mm), an d mixed intestinal/transitional-lined cysts (N = 2; 3%; average diamet er 2.5 mm). Focal rupture of dilated intestinal glands with interstiti al pooling of mucus was not uncommon, and marked dystrophic calcificat ion was found in 1 case within a large collection of extracellular muc us. This series confirms that inflammation, fibrosis, and glandular ov ergrowth by transitional epithelium are common occurrences at ureteroi leal anastomosis sites. Subsequent gland rupture may result in sizable accumulations of interstitial mucus, and rarely in marked dystrophic calcification.