Transition to adulthood with a bladder augmentation: histopathologic concerns

Abstract

Aim:To investigate the histopathologic changes in native bladder and gastrointestinal segment, the relation between histopathologic changes, type of operation and the period passed over operation in patients with bladder augmentation.Materials and methods:Twenty consecutive patients were enrolled in this study. Histopathologic evaluation of the cystoscopic mucosal biopsies from native bladder and enteric augment was performed in all patients.Results:Active or chronic non-specific inflammation of various degrees was found in all specimens except two. Metaplastic changes were detected in 3 patients. Two patients had squamous metaplasia (one focal, one extensive) and one patient had intestinal metaplasia. All metaplastic changes were found in native bladder specimens. The type of augmentation in patients with metaplastic changes were ileocystoplasty and sigmoidocystoplasty. No signs of malignancy were detected in any patient.Conclusion:The complexity of the disorders requiring bladder augmentation does not let the surgeons to draw a clear line between different groups of complications including malignancy formation. However, due to challenging course of the augmentation procedure itself, surgeons should be well aware of the possibility of malignancy development.

Re: Transition to adulthood with a bladder augmentation: histopathologic concerns

“…Mammadov et al reported no malignant histology in the study but did detect 2 cases of squamous metaplasia and 1 case of intestinal metaplasia ( 1 ). One case of squamous metaplasia had a history of bladder stones similar to the case reported by Floyd Jr et al ( 3 ).…”

“…We read with interest the recent paper by Mammadov et al examining the concerns regarding histological changes in adult neurogenic patients who have undergone bladder augmentation with bowel interposition as an adolescent or in childhood ( 1 ).…”

Association of spina bifida with cancer

“…(70,71). "Intestinalization," or the development of histologic findings typical of bowel in the native bladder following augmentation, has also been reported (72). In the past, common practice was to perform annual evaluation not only of the augmented reservoir (73) but also of catheterizable channels, since neoplasia has been reported in an appendicovesicostomy (74).…”