New Surgical Treatment of Bladder Tumours: Mucosal Denudation of the Bladder

Harada, Naohiko; Yano, H.; Ohkawa, Tadashi; Misse, T; Kitahara, Takashi; Nagahara, A

doi:10.1111/j.1464-410x.1965.tb09644.x

Cited by 31 publications

(9 citation statements)

References 5 publications

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“…If the epithelium is peeled off, or scraped away, the damaged surface is rapidly re-epithelialized by spread of cells from any remaining fragments of the epithelium and also by epithelial outgrowth from the ureters and urethra (Connolly, Morales, Minnaker & Raeburn, 1971). I n man, regeneration of bladder epithelium is said to take about 6 weeks (Lund, Stripping of the epithelium has been advocated as a method of treating bladder papillomatosis in man, on the assumption that the discarded neoplastic epithelium could be replaced by a newly generated, normal urothelium from the urethra and ureters (Baker, Thehan & Kelly, 1959;Harada et al, 1965;Lund, 1969). I n the dog, epithelialization of seromuscular grafts in the bladder wall started after about 7 days and the transitional epithelium was complete by the 19th day (Grotzinger et al, 1954).…”

Section: T H E Transitional Epitheliummentioning

confidence: 99%

The Mammalian Urinary Bladderan Accommodating Organ

1975

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Summary 1. Urinary bladders are found in the amphibia, chelonian reptiles and mammals. In these orders liquid urine is stored in the bladder and eliminated at intervals from the body by micturation. 2. In the amphibia and chelonian reptiles, the urinary bladder is a functional extension of the renal tubules. The composition of the urine in the bladder is modified by the active movement of water and ions across the bladder wall, and these transporting processes are under hormonal control. The bladder acts as a water reservoir which can be drawn upon in times of water shortage. 3. The mammalian bladder separates two widely differing water phases, namely the urine which is frequently hypertonic to the blood and the tissue fluids which are isotonic. Its function is uniquely one of storage, and no adjustment to the composition of the urine is made by active transport of either water or ions across the bladder wall. 4. The epithelium lining the mammalian bladder is the site of the osmotic barrier between urine and tissue fluids. This functional barrier is dependent on the structure of the epithelium and is maintained despite large alterations in the surface area of the epithelium as the bladder rapidly contracts, or slowly dilates. 5. The epithelium is of mixed mesodermal and endodermal origin, is transitional in type and is usually 3 or 4 cell‐layers thick. If this urothelium is damaged, it has a high capacity for regeneration and rapidly re‐establishes an intact barrier over the luminal surface. 6. The superficial cell layer of this epithelium is composed of large, polyploid, highly differentiated squamous cells which have a long life span. These cells are limited on their free surface by an unusual, angular, semi‐rigid luminal membrane. This membrane is assembled in the Golgi complex. 7. The luminal membrane is composed of thickened, discoidal plaques, separated by narrow bands of thinner membrane. When the bladder contracts, the membrane folds along the thinner ‘hinge’ regions, and the rigid discoidal plates invaginate to form fusiform, cytoplasmic vacuoles. The thickened plaques contain a hexagonal lattice of sub‐units, spaced at 14 nm centre‐to‐centre. Each sub‐unit in the lattice is itself composed of 12 smaller particles. These particles may be envisaged as small rods 3 nm in diameter and 12 nm long, and are inserted into matrix from which they project on the luminal face by about 3 nm. Each rod has a central hydrophobic portion separating distal hydrophilic ends. 8. The chemical composition of this luminal membrane is unusual. Cerebroside is a major component of the polar lipid fraction and there is an unusually high proline content in the protein fraction. When the mucoproteins are adequately dispersed, and the proteins separated by electrophoresis, a few major proteins are revealed in 33000–80000 dalton range of molecular weight. 9. If the normal structure of the luminal membrane is altered, either by physical damage or by failure of the cells to produce it, the barrier function of the epithelium is lost. 10...

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Section: T H E Transitional Epitheliummentioning

confidence: 99%

The Mammalian Urinary Bladderan Accommodating Organ

1975

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“…Seromuscular grafts and deepithelialized bowel segments, either alone or over a native urothelium, have also been attempted (30 -35). Keeping the urothelium intact avoids the complications associated with use of bowel in continuity with the urinary tract (31,32). An example of this strategy is the combination of the techniques of autoaugmentation with those of enterocystoplasty.…”

Section: Bladdermentioning

confidence: 99%

Bioengineered Tissues for Urogenital Repair in Children

Atala

2008

Pediatr Res

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“…In preclinical models, seromuscular flaps used for bladder augmentation showed normal reepithelialization, but the tissue experienced significant shrinkage that severely limited the clinical feasibility of this technique [46] . The use of such de-epithelialized segments over native urothelium was also attempted but showed little success [47] . Today, the use of seromuscular grafts has been mostly abandoned.…”

Section: Basic Principles Of Regenerative Medicinementioning

confidence: 99%