Progressive Villous Atrophy of the Ileum Used as a Urinary Conduit

Summary An ileal conduit used as a urinary bladder in man provides an unusual opportunity to follow the morphological and functional changes that occur in a segment of small intestine when its environment is modified and its function changed. The histological alterations in ileal bladder occurring at various intervals following surgical construction were studied. Twenty-four biopsies of ileal bladder mucosa were obtained from 22 patients from 1 week to nearly 6 years after surgery. Progressive villous atrophy was noted. The earliest changes were already present at 1 week. Blunting and broadening of the villi progressed to loss of villous structure and flattening of the mucosa. There was individual variation in the rate at which villous atrophy developed, but in most patients it was fairly complete by 2 years.