Correlation Between Clinical And Morphological Changes In Cases Of Ectopia Vesica Treated By Ileal Graft

Khedr, El Sayed G.; Samaha, Abdelhady
June 2008
Egyptian Journal of Hospital Medicine;Jun2008, Vol. 31, p203
Academic Journal
Introduction : Ectopia vesica is the most severe of the commoner congenital malformations of the urinary system where the urinary bladder lumen is exposed and urine incontinence is present. Treatment has taxed the skill of surgeons for over hundred years and intestinal segments are still the classical graft used for treatment of the condition.aim of work : The aim of this study was determined to evaluate the ileal tissue used in repair of urinary bladder defects and its mucosal morphological changes in the wall at different intervals after surgery in human cases aiming to correlate them with their clinical condition. Subjects and methods :Cystoscopy guided biopsy specimens from the ileal grafts of five male children (mean age 8 years, range 5-10 years) who had undergone bladder repair using ileal wall were assessed by light microscopy from 1 month to 2 years after operation. The morphology was compared with control specimens from the same tissue at the time of repair. Results : Light microscopy showed decrease in goblet cells, and marked congestion in the wall associated with inflammatory cell reaction. These early microscopic changes were gradually disappeared and the absorptive and secretory mucosa of the ileum was gradually changed into protective mucosa with multilayer epithelium. In conclusion :The mucosa of the ileum adapted well to the new environment as a urinary neobladder,and the microscopic changes explained the associated clinical signs and symptoms after surgery including the early hematuria, massive exfoliated cells and mucus excretion.


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