Morphologic Changes in Intestinal Mucosa with Urinary Contact--Effects of Urine or Disuse?

Abstract

No AccessJournal of UrologyInvestigative Urology1 Jul 1996Morphologic Changes in Intestinal Mucosa with Urinary Contact--Effects of Urine or Disuse? T. Davidsson, B. Carlen, E. Bak-Jensen, R. Willen, and W. Mansson T. DavidssonT. Davidsson More articles by this author , B. CarlenB. Carlen More articles by this author , E. Bak-JensenE. Bak-Jensen More articles by this author , R. WillenR. Willen More articles by this author , and W. ManssonW. Mansson More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)66006-3AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: To evaluate the morphological changes induced in bypassed ileal and colonic segments and the influence of the urine on the mucosal histology. Materials and Methods: In a rat model, an isolated ileocolonic segment was used for construction of an ileocolocystoplasty or an exteriorized blind loop. Sham-operated animals were used for control. Results: In ileal mucosa, villi and microvilli were better preserved when exposed to urine than when deprived of contact with luminal content. Numerical reduction of microvilli was found in colonic mucosa deprived of luminal content. In colonic mucosa exposed to urine some areas were denuded of microvilli and showed blebs. Findings of intact tight junctions in all specimens implied that an important morphological requirement of maintained epithelial barrier function is present in mucosa deprived of normal luminal stimulation and also after contact with urine. The intracellular ultrastructural changes in both colon and ileum were similar in the 2 groups. However, there were more solitary ribosomes lying free in the mucosa exposed to urine, indicating depressed or arrested protein synthesis. Conclusions: Mucosa in contact with urine seems to maintain surface characteristics better than mucosa deprived of luminal stimulation, indicating that factors present in the urine may be important for the epithelial cell physiology. Certain intracellular changes were found more often in mucosa exposed to urine, but there were no major differences. The changes noticed may indicate enterocyte adaptation to a new physiologic environment. References 1 : Nutrition, operations and intestinal adaptation. J. Parenter. Enter. Nutr.1988; 12: 299. Google Scholar 2 : Amino acid and peptide absorption in bypassed jejunum following jejunoileal bypass in rats. Dig. Dis. Sci.1981; 26: 107. Google Scholar 3 : Intestinal structure and function after small bowel by-pass in the rat. Clin. Sci.1972; 43: 731. Google Scholar 4 : Histological and scanning electron microscopic alterations in ileal conduit depending on time factor. Urol. Int.1990; 45: 84. Google Scholar 5 : 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. Google Scholar 6 : Absorption of L-phenylalanine in human ileal reservoirs exposed to urine. Urol. Res.1988; 16: 321. Google Scholar 7 : Morphologic and functional alterations of intestinal segments following urinary diversion. J. Urol.1993; 149: 664. Link, Google Scholar 8 : Regulation of gastrointestinal mucosal growth. Physiol. Res.1988; 68: 456. Google Scholar 9 : Systemic factors are trophic in bypassed rat small intestine in the absence of luminal contents. Gut1990; 31: 311. Google Scholar 10 : Evidence for both luminal and systemic factors in the control of rat intestinal epithelial replacement. Clin. Sci. Mol. Med.1976; 50: 139. Google Scholar 11 : Effect of neurotensin on gut mucosal growth in rats with jejunal and ileal Thiry-Vella fistulas. Gastroenterology1992; 103: 1254. Google Scholar 12 : Mucosal morphology in isolated bowel segments: importance of exposure to luminal contents. J. Pediatr. Surg.1992; 27: 1061. Google Scholar 13 : Effects of luminal nutrition and metabolic status on in vivo glucose absorption. Am. J. Physiol.1981; 240: G432. Google Scholar 14 : Disuse atrophy of the intestinal tract. Clin. Nutr.1984; 3: 169. Google Scholar 15 : Colostomy closure promotes cell proliferation and dimethylhydrazine-induced carcinogenesis in rat distal colon. Gastroenterology1981; 81: 475. Google Scholar 16 : Progressive villous atrophy of the ileum used as a urinary conduit. Gastroenterology1967; 52: 859. Google Scholar 17 : Mucosal ultrastructure of continent cecal reservoir for urine and its ileal nipple valve 2-9 years after construction. J. Urol.1990; 143: 372. Abstract, Google Scholar 18 : Experimental oncology. In: The Laboratory Rat. Edited by . Orlando: Academic Press1980: 119. Google Scholar 19 : Mucosal morphology and histochemistry of the continent cecal reservoir for urine. J. Urol.1988; 139: 1199. Link, Google Scholar 20 : Histological and histochemical changes in the colon mucosa after ureterosigmoidostomy or colonic conduit. Eur. Urol.1988; 15: 248. Google Scholar 21 : Mucous secretion in rat colonic mucosa during carcinogenesis induced by dimethylhydrazine. A morphological and histochemical study. Br. J. Cancer1975; 32: 60. Google Scholar 22 : Histochemical changes after ureterosigmoidostomies and colonic diversion. Br. J. Urol.1985; 57: 700. Google Scholar 23 : Abnormalities of colonic mucin secretion and metabolic changes after internal urinary diversion for bladder extrophy. A prospective study. Br. J. Urol.1991; 67: 477. Google Scholar 24 : Cell injury and adaptation. In: Basic Pathology. Edited by . Philadelphia: W. B. Saunders Company1992: 3. Google Scholar 25 : Decreased absorption of 22Na and 36Cl in ileal reservoirs after exposure to urine. An experimental study in patients with continent ileal reservoirs for urinary or fecal diversion. Urol. Res.1991; 19: 249. Google Scholar 26 : Enzyme activities and morphological appearance in functioning and excluded segments of the small intestine after shunt operation for obesity. Gut1979; 20: 553. Google Scholar 27 : Multivesicular bodies and R-bodies. In: Ultrastructural Pathology of the Cell and Matrix: A Text and Atlas of Physiological and Pathological Alterations in the Fine Structure of Cellular and Extracellular Components. London: Butterworths1988: 602. 1072-1074. Google Scholar 28 : C-bodies and R-bodies in the epithelial cells of normal and diseased human rectum. Arch. Pathol. Lab. Med.1977; 101: 437. Google Scholar 29 : Metabolism and effects of epidermal growth factor and related growth factors in mammals. Endocr. Rev.1990; 11: 418. Google Scholar 30 : Histological changes in ileal conduits. J. Urol.1984; 132: 1108. Link, Google Scholar 31 : Mucosal morphology of ileal conduits with particular reference to urinary infections. Eur. Urol.1986; 12: 201. Google Scholar Departments of Urology and Pathology, University Hospital, Lund, Sweden.© 1996 by American Urological Association, Inc.FiguresReferencesRelatedDetails Volume 156Issue 1July 1996Page: 226-232 Advertisement Copyright & Permissions© 1996 by American Urological Association, Inc.MetricsAuthor Information T. Davidsson More articles by this author B. Carlen More articles by this author E. Bak-Jensen More articles by this author R. Willen More articles by this author W. Mansson More articles by this author Expand All Advertisement PDF DownloadLoading ...