title: Ileocystoplasty in rats: metabolic, renal and enteropatch changes in a mid- and long-term follow-up.
abstract: BACKGROUND
  Bladder augmentation predisposes humans to many metabolic, renal and enteropatch changes. Our aim was to evaluate in a rat model of ileocystoplasty mid- and long-term urinary, metabolic, renal and graft changes.
  
  
  METHODS
  We performed an ileocystoplasty and a sham operation in 30 rats. Seven augmented rats and 3 sham-operated animals were euthanized after 1, 3 and 6 months. We performed urinalysis, urine culture and blood sampling for serum electrolytes and urea. Histopathological changes of the ileal patch and kidneys were also evaluated.
  
  
  RESULTS
  The urine cultures were positive in 14.3, 57 and 71%, respectively, 1, 3 and 6 months after surgery. Urinary pH, serum chloride and urea of the augmented group were significantly higher. Bladder calculi were formed in 23.8% of ileocystoplasty. Histopathological examination showed urothelialization of the graft with hyperplastic/metaplastic changes. The kidneys showed glomerular depletion and a marked distal tubular ectasia.
  
  
  CONCLUSIONS
  Our data showed that, in a mid- and long-term follow-up, rat bladders subjected to ileocystoplasty displayed hyperchloremic metabolic acidosis, electrolyte imbalance, enhanced serum blood urea levels and glomerular/tubular changes. Hyperplastic and/or metaplastic changes at the junctional zone were observed. Our experimental results suggest that frequent monitoring of renal function and surveillance of humans who have undergone ileocystoplasty are recommended.
authors.affiliation: Department of Urology, Polyclinic Hospital, University of Messina, Messina, Italy. arenasal @ inwind.it
authors.forename: Salvatore
authors.initials: S
authors.lastname: Arena
authors.forename: Francesco
authors.initials: F
authors.lastname: Arena
authors.forename: Carmine
authors.initials: C
authors.lastname: Fazzari
authors.forename: Letteria
authors.initials: L
authors.lastname: Minutoli
authors.forename: Tiziana
authors.initials: T
authors.lastname: Russo
authors.forename: Domenica
authors.initials: D
authors.lastname: Altavilla
authors.forename: Francesco
authors.initials: F
authors.lastname: Squadrito
authors.forename: Piero Antonio
authors.initials: PA
authors.lastname: Nicòtina
authors.forename: Carmelo
authors.initials: C
authors.lastname: Romeo
authors.forename: Carlo
authors.initials: C
authors.lastname: Magno
mesh_terms: D000138:Acidosis / Q000209:etiology / Q000378:metabolism; D000818:Animals; D005260:Female; D006863:Hydrogen-Ion Concentration; D007082:Ileum / Q000473:pathology / Q000601:surgery*; D007678:Kidney Glomerulus / Q000378:metabolism / Q000473:pathology; D007684:Kidney Tubules / Q000378:metabolism / Q000473:pathology; D008297:Male; D051381:Rats; D017208:Rats, Wistar; D013997:Time Factors; D014508:Urea / Q000097:blood; D016482:Urinalysis; D001743:Urinary Bladder / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D016476:Urinary Reservoirs, Continent / Q000009:adverse effects; D014556:Urine / Q000737:chemistry / Q000382:microbiology; D014882:Water-Electrolyte Balance
chemical_list: D014508:Urea