The fate of the mucosa in bladders augmented with demucosalized sigmoid colon; long term histological results
Purpose Bladder augmentation (BA) using demucosalized sigmoid colon (DSC) is associated with a decrease in mucus production. The aim of this study is to determinate the histological changes at various times after augmentation. Material and methodsS 24 specimens were taken from 20 patients who had undergone BA using DSC over 7 years (1998-2005). Biopsy was done in 3 different points of the augmented patch (9-12-3 o'clock). In children with a closed bladder neck a trans-vesical trochar was used. Histopathology (H+E) results were compared at different post augment periods. The biopsies were compared with 2 cases of BA where sigmoid colon without demucosalisation was used (SCWD)(>10 years). Results The mean age at biopsy was 12 years (range 4–15y) with a mean post BA of 39 months (range 12–84m). On endoscopy there were 2 groups; one ( 3 years where the patch was covered completely with intestinal mucosa (n = 15). The histology of the early biopsies ( 36 months the patch was mostly covered with intestinal mucosa with atrophic glands surrounded by fibrotic tissue and no signs of urothelium. In the 2 cases of BA with SCWD the intestinal glands were normal. Conclusions This study has demonstrated regrowth of sigmoid colon mucosa, which may begin from intestinal mucosa remnants (“islets”), noted on specimens taken