Home Chapter Home Jobs Conferences Fellowships Books
Advertisement
Bladder
Acquired non-neoplastic anomalies
Urinary diversion / neobladder
Author: Nat Pernick, M.D. (see Authors page)
Editor: name, affiliation
Revised: 13 February 2010, last major update - February 2010
Copyright: (c) 2002-2010, PathologyOutlines.com, Inc.
Definition
=========================================================================
● Portions of ileum or colon used in adults and children to treat congenital anomalies, dysfunctional bladder or post-cystectomy for malignancy
● Options are to enlarge capacity of bladder (augmentation), channel urine into temporary artificial reservoir while a new bladder is being created or create a neobladder (new bladder after cystectomy)
Terminology
=========================================================================
●
Epidemiology
=========================================================================
●
Sites
=========================================================================
●
Etiology
=========================================================================
●
Clinical features
=========================================================================
● Ileal neobladder produces good functional results (J Urol 1999;161:422)
Complications:
● Intestinal adenocarcinoma in colonic conduits, reflux but only rare renal failure in ileal conduits, highest risk of adenocarcinoma is in augmentation cystoplasty (J Urol 1997;157:482)
● Monitor for carcinoma with cytology (direct smears after centrifugation)
● Note: must also monitor nonfunctionalized bladder, if present (J Urol 2006;176:620)
Prognostic factors
=========================================================================
Case reports
=========================================================================
● 39 year old male with tubular adenoma in ileal segment 34 years after augmentation ileocystoplasty (Diagn Pathol 2007 Aug 13;2:29)
● 67 year old man with adenocarcinoma 20 years after ileal neobladder (Urology 2006;68:1343)
Treatment
=========================================================================
●
Clinical images
=========================================================================
Continent urinary diversion using ileum
Gross description (Macroscopy)
=========================================================================
●
Gross images
=========================================================================
Micro description (Histopathology)
=========================================================================
● Inflamed, atrophic and partially denuded epithelium
● Candida in ileal conduits
Micro images
=========================================================================
Tubular adenoma with high grade dysplasia
after augmentation ileocystoplasty
Cytology description
=========================================================================
●
Cytology images
=========================================================================
Cytology from ileal conduit urine
Positive stains
=========================================================================
●
Negative stains
=========================================================================
●
Electron microscopy descriptions
=========================================================================
●
Electron microscopy images
=========================================================================
Molecular / cytogenetics description
=========================================================================
●
Molecular / cytogenetics images
=========================================================================
Differential Diagnosis
=========================================================================
● Normal intestinal cells: aggregates are normally present in urinary diversion specimens, may resemble malignancy
Additional references
=========================================================================
End of Bladder > Acquired non-neoplastic anomalies > Urinary diversion
This information is intended for physicians and related personnel, who understand that medical information is often imperfect, and must also be interpreted in the context of a patient's clinical data using reasonable medical judgment. This website should not be used as a substitute for the advice of a licensed physician.
All information on this website is protected by copyright of PathologyOutlines.com, Inc. Information from third parties may also be protected by copyright. Please contact us at copyrightPathOut@gmail.com with any questions (click here for other contact information).