MORPHOLOGICAL TRANSFORMATION OF INTESTINAL GRAFT AFTER CYSTECTOMY WITH ORTHOTOPIC PLASTIC OF THE URINARY BLADDER

Introduction. The histomorphological state and mechanisms of transformation of the intestinal epithelium of the orthotopic urinary bladder are unexplored.

Purpose of research. The study the morphological adaptive and compensatory changes in the intestinal graft wall (IGW) and their relationship with homeostasis at various stages after surgical treatment. Materials and methods. The morphological state of the intestinal graft wall (IGW) was studied in 42 patient’s cystectomy undergoing with the formation of an orthotopic intestinal bladder (15-ileum, 27-sigmoid) at terms from 1 to 6.5 months and 1 year or more after the treatment.

Results. Morphological changes occurring in the IGW wall begin with the moment of urine entering the lumen, which occurs in combination with changes in the stereotyped dynamics of the organ. Expressed changes are observed in all parts of the wall of the small and large intestine. There is regeneration and restructuring of the epithelium, expressed in atrophy and a decrease in the number of suction cylindrical cells and an increase in the number of mucus-forming goblet elements, terminating by 12 months and more after the operation. This combined with a decrease in the number and size of villi and crypts, reduction of the lymphatic channel and sclerosis of the blood vessels and stroma blocks suction. An increase in the number of mucus-forming goblet cells provides a barrier that protects the IGW mucosa from the effects of urine.

Conclusion. Morphological changes occurring in the IGW wall under the influence of urine contribute to the preservation of homeostasis and are identical in the thick and thin-intestinal variant of plastic of the bladder.

Disclosure: The study did not have sponsorship. The authors have declared no conflicts of interest

1. Kogan MI eds. Cancer of the bladder (classic and novaTIon). M.: Medforum; 2017. (In Russ.)

2. Tsvetov EP. Morphological changes of the graŌ with intesTInal plasty of the mochevskoy bladder. A new surgeon. Archive. 1961;1:48-54. (in Russ.)

3. Shakhov EV. Histological characterisTIcs of the small intesTIne graŌ used for plasty of the bladder in the experiment. Materials of the 2nd All-Union Symposium. Gorky; 1973. (in Russ.)

4. Komyakov BK, Anichkov NM, Bodareva N.V. Morphological adaptaTIon of arthriTIs bladder. Materials of Plenum ROU. Krasnodar; 2010. (in Russ.)

5. Perepechay VA. OpTImizaTIon of surgical treatment of musculo-invasive and locally advanced bladder cancer. From Diss. DMS. Rostov-on-Don. 2016:420. (in Russ.)

6. Yuan J, Lin H, Li P, Zhang R, Luo A, Berardinelli F, Dai Y, Wang R. Molecular mechanisms of vacuum therapy in penile rehabilitaTIon: a novel animal study. EurUrol. 2010;58:773-80. DOI:10.1016/j.eururo.2010.07.005

7. Lin H, Yang W, Zhang J, Dai Y, Wang R. Penile rehabilitation with a vacuum erectile device in an animal model is related to an antihypoxic mechanism: blood gas evidence. Asian J Androl. 2013;15:387. DOI:10.1038/ aja.2013.18

8. Yuan J, Hoang A, Romero C, Lin H, Dai Y, Wang R. Vacuum therapy in erecTIle dysfuncTIon-science and clinical evidence. Int J Impot Res. 2010;22:211-9. DOI:10.1038/ ijir.2010.4