9 years at surgery. Median followup
was 8.0 years. Most procedures used a composite of gastric and ileal tissue. All patients were continent of urine and had a stable upper urinary tract. Median bladder capacity was 400 ml. Postoperative complications included reservoir stones (8 patients), febrile urinary tract infection SHP099 (8), metabolic acidosis (6), small bowel obstruction (4), bladder perforation (4) and pelvic lymphocele (1). Five patients had difficulty with catheterization due to stomal stenosis. Gross hematuria with clots developed in 1 patient with anuria who had a gastroileal neobladder and was awaiting renal transplantation. No other patient with a gastric component had the hematuria-dysuria syndrome. Five patients had end stage renal disease and subsequently underwent successful renal transplantation. No upper urinary
tract deterioration was observed, and no malignant transformation has occurred.
Conclusions: Creation of a continent neobladder is a reconstruction option in children when bladder augmentation is not feasible. However, complication rates are not insignificant, underscoring the need for careful long-term followup.”
“Purpose: Dextranomer/hyaluronic acid implantation is associated with a granulomatous inflammatory reaction, replaced by fibrosis. Appearance of myofibroblasts is considered a crucial event in fibrosis, and CD68 positive cells and other factors are implied in their activation. Mast cells are a source of these factors and tryptase can induce fibroblast to express a-smooth muscle actin, which is characteristic
of myofibroblasts. We evaluated histological MK-8931 changes in refluxing ureters treated with dextranomer/hyaluronic acid and immunolocalized CD68 positive cells, tryptase mast cells and myofibroblasts.
Materials and Methods: We performed histological, histochemical and immunohistochemical analyses in 22 refluxing ureters treated with dextranomer/hyaluronic acid in comparison with 17 refluxing ureters who underwent ureteral reimplantation but did not receive endoscopic bulking agent. We used CD68 antibody for monocytes/macrophages and epithelioid cells, mast cell tryptase mouse antibody for mast cells, and a-smooth muscle actin and vimentin antibodies for myofibroblasts. The area of the ureteral lumen in dextranomer/hyaluronic acid treated and Taselisib cost untreated ureteral endings was measured.
Results: Sirius red documented a major grade of histological lesions in dextranomer/hyaluronic acid treated refluxing ureters. CD68 and tryptase mast cell staining showed a significant enhancement of positive cells in dextranomer/hyaluronic acid treated refluxing ureters. Immunostaining for a-smooth muscle actin and vimentin displayed a myofibroblastic invasion in dextranomer/hyaluronic acid. Measurement of surface in treated refluxing ureters was significantly less than in untreated refluxing ureters.