Introduction: The intestinal mucosa undergoes significant atrophic changes when it is used to reconstruct the urinary tract. We analyzed the ultrastructural changes of intestinal mucosa in the orthotopic neobladder on the basis of our clinical experience. Patients and Methods: Fifteen male patients with an ileal neobladder underwent endoscopic biopsy at different postoperative intervals. Results: No significant changes were observed 3 months after surgery. After 6 and 12 months, the structure of the microvilli was modified significantly. No other substantial changes after 24 months were observed. Conclusions: Progressive modifications occur in the cytoplasmic structures involved in the absorptive process. They do not seem to begin before 3 months and are almost totally completed after 1 year.

1.
Deane AM, Woodhouse CR, Parkinson MC: Histological changes in ileal conduits. J Urol 1984;132:1108–1111.
2.
Carlén B, Willén R, Månsson W: Mucosal ultrastructure of continent cecal reservoir for urine and its ileal nipple valve 2–9 years after construction. J Urol 1990;143:372–376.
3.
Månsson W, Willén R: Mucosal morphology and histochemistry of the continent cecal reservoir for urine. J Urol 1989;139:1199–1201.
4.
Philipson BM, Kock NG, Höckenström T, Norlén LJ, Ahrén C, Hansson HA: Ultrastructural and histochemical changes in ileal reservoir mucosa after long-term exposure to urine. A study in patients with continent urostomy (Kock pouch). Scand J Gastroenterol 1986;21:1235–1244.
5.
Guerrero-Alcazar M, Gonzalez-Angulo A, Ortiz-Quesda F: Histochemical and ultrastructural changes observed in the mucosa of the ileal conduit. J Urol 1970;104:406–412.
6.
Watson DW, Cockett AT: Intestinal mucosa of dogs with ileocystoplasties. Long-term histologic and histochemical changes. Urology 1973;2:385–388.
7.
Garner JW, Goldstein AM, Cosgrove MD: Histologic appearance of the intestinal urinary conduit. J Urol 1975;114:854–857.
8.
Lilien OM, Camey M: 25-year experience with replacement of the human bladder (Camey procedure). J Urol 1984;132:886–891.
9.
Leandri P, Rossignol G, Gautier JR, Quintens H, Lasserre E, Caissel J: Ileal low-pressure bladder replacement: Camey type II. Stapling technique and preliminary results (57 cases, 1987–1989). Eur Urol 1990;18:161–165.
10.
Pagano F, Artibani W, Ligato P, Piazza R, Garbeglio A, Passerini G: Vescica ileale Padovana: a technique for total bladder replacement. Eur Urol 1990;17:149–154.
11.
Nurse DE, Mundy AR: Metabolic complications of cystoplasty. Br J Urol 1989;63:165–170.
12.
Koch MO, Gurevitch E, Hill DE, Mc Dougal WS: Urinary solute transport by intestinal segments: a comparative study of ileum and colon in rats. J Urol 1990;143:1275–1279.
13.
Koch MO, McDougal WS, Thompson CO: Mechanism of solute transport following urinary diversion through intestinal segments: an experimental study with rats. J Urol 1991;146:1390–1394.
14.
McDougal WS: Metabolic complications of urinary intestinal diversion. J Urol 1992;147:1199–1208.
15.
Boyd SD, Schiff WM, Skinner DG, Lieskowsky G, Kanellos A, Klimaszewsky A: Prospective study of metabolic abnormalities in patient with continent Koch pouch urinary diversion. Urology 1989;33:85–88.
16.
Philipson BM, Kock NG, Jagenburg R, Ahrén C, Norlén L, Robinson JW, Menge H: Functional and structural studies of ileal reservoirs used for continent urostomy and ileostomy. Gut 1983;24:392–398.
17.
Hall MC, Koch MO, Halter SA, Dahlstedt SM: Morphologic and functional alterations of intestinal segments following urinary diversion. J Urol 1993;149:664–666.
18.
Studer UE, Merz WV, Ritter EP, Luescher D, Turner WH, Garros K, Roesler H: Metabolic adaptation of small bowel when used for an ileal bladder substitute. The 18F-FDG absorption test (abstract). J Urol 1994;151:500.
19.
Roosen A, Gerharz EW, Roth S, Woodhouse CR: Bladder, bowel and bones – skeletal changes after intestinal urinary diversion. World J Urol 2004;22:200–209.
20.
Khafagy M, Shaheed FA, Moneim TA: Ileocaecal versus ileal neobladder after radical cystectomy in patients with bladder cancer: a comparative study. BJU Int 2006;97:799–804.
21.
Miyake H, Hara S, Eto H, Arakawa S, Kamidono S, Hara I: Significance of renal function in changes in acid-base metabolism after orthotopic bladder replacement: colon neobladder compared with ileal neobladder. Int J Urol 2004;11:83–87.
22.
Studer U: Continent urinary reservoirs (editorial). J Urol 1994;151:341–342.
23.
Lockhart JL, Davies R, Persky L, Figueroa TE, Ramirez G: Acid-base changes following urinary tract reconstruction for continent diversion and orthotopic neobladder replacement. J Urol 1994;152:338–342.
24.
McDougal WS: Urinary tract reconstruction (editorial). J Urol 1994;152:343–344.
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