Mucosal adaptation changes after urinary diversion Saad Eissa NCI-Cairo University
intact junctional complexes. • prominent filamentous core rootlets, with haphazard orientation.
Solitary, apically located ribosomes were more abundant in ileal than in colonic mucosa
Some areas of colonic mucosa were denuded of microvilli and showed bleb formation.
Electron-dense particles, lipid depositions, situated in Golgi apparatus and lying free in the cytoplasm.
In summary • changes that occur in ileal or colonic segments of urinary diversion -when they are chronically exposed to urine are: • Ileal or colonic Mucosa in contact with urine seems to maintain surface characteristics ( intact desmosomes and tight junctions) • In ileal mucosa, villi and microvilli were better preserved when exposed to urine . • In colonic mucosa exposed to urine some areas were denuded of microvilli and showed blebs.
intact tight junctions which indicate that an important morphological requirement of maintained epithelial barrier function is present in mucosa deprived of normal luminal stimulation or after contact with urine. • there were more solitary ribosomes lying free in the mucosa exposed to urine, indicating depressed or arrested protein synthesis. • The changes noticed may indicate enterocyte adaptation to a new physiologic environment.
Fortunately, the clinical significance of electrolyte abnormalities resulting from urinary diversion through ileal or colonic segments, at least in the short term, appears to be minimal in the patient with normal renal function.