[Comparative clinical and morphofunctional evaluation of the intestinal and colonic gastric orthotopic urinary reservoirs at different times of functioning].

The complex clinical and morphological evaluation of different variants of orthopic urinary reservoir (OUR) at different times of functioning was performed. During 1996-2012, orthotopic cystoplasty was performed in 265 patients (ileocystoplasty--in 204, gastrocystoplasty--in 24, and sigmocystoplasty--in 29 patients). There were 207 (77%) men and 61 (23%) women aged 22-75 years (mean age, 57.5 +/- 1,3 years). Cold biopsy over time (1 to 6) was performed in 105 patients. The total number of biopsies was 150. Duration of morphological study was 2-12 years. Clinical examination included assessment of acid-base balance and electrolyte balance of within 3-24 months, evaluation of urodynamic parameters (OUR volume, daytime and nighttime continence, micturition volume), assessment of the frequency and the nature of infection, resistance of microorganisms to antibiotics and the symptoms of inflammatory reaction in period 1-90 months after surgery. Morphological study included histological, histochemical, immunohistochemical, and morphometric methods. Application of a set of clinical, morphological, immunohistochemical examinations is a premise for individual choice of cystoplasty, and creates the preconditions for the correction of the process of adaptation to the OUR, regardless of its form in the early and later stages of its functioning. Due to the good adaptation to the new conditions in all three types of OUR and absence of trends to malignant transformation of its mucosa, the ileocystoplasty is method of choice for creation of OUR, and gastrocystoplasty and sigmocystoplasty are alternatives.

[Adaptive changes in enteric explants instead of the urinary bladder].

One hundred and twenty-two biopsy specimens of enteric explants (orthotopic urinary reservoirs (OUR)) placed instead of the neoplastic urinary bladder were studied in 94 patients. The OUR wall changes were shown to be compensatory and adaptive and to appear as: (1) progressive atrophy and a reduction in enteric villae; brush-border enterocyte replacement by goblet cells secreting syalomucins with the appearance of the lining devoid of the brush border and secretion; (2) preservation of crypts as active regeneration areas with varying reductions, prevalence of goblet cell differentiation; and preservation of programmed differentiation; (3) adaptive muscular layer hypertrophy; (4) no morphological manifestations of both hyperplasia and dysplasia of the surface and crypt epithelium; (5) no morphological signs of destructive inflammation and sclerosis deformans.