Changes in the Urinary Bladder Caused by Short-term Permanent Catheter Insertion


Authors: L. Peychl;  R. Žalud
Authors‘ workplace: Oddělení patologie, Oblastní nemocnice Kolín, a. s.
Published in: Čas. Lék. čes. 2008; 147: 325-329
Category: Original Article

Overview

Background.
Short-term urinary bladder drainage using a permanent Foley catheter is practised frequently in hospitals. The catheter usually hurts the bladder mucosa and submucosa to various degrees. The aim of this study was to show pathological changes observed during a time period of one to 30 days of catheter treatment.

Methods and Results.
Samples for histological testing were taken from the posterior wall of the bladder of deceased patients. The posterior wall exhibited maximal injury. Same steps were done in 10 bladders of the deceased patients who had not been catheterised at all. There were 41 patients in the tested group, of an average age 70 years (22 men and 19 women). In microscopy the mucosa was oedematous, hyperaemic with ectatic vessels and haemorrhages. Polyps were also seen, some of them haemorrhagic. Polypous cystitis was revealed in 29 cases (70%), and various mucosal defects in 12 cases (29%). A predominance of fibroblasts was observed in the reactive stromal cells of the bladder wall.

Conclusions.
Polypous cystitis develops already in the first days after permanent catheter insertion. The recent polyps present an inflammation caused by mechanical injury. The number of reactive stromal cells increases only partly on the dependence on the duration of permanent catheter treatment. These are abundant in the polyps and where mucosal defects occur. The presence of these cells may also be influenced by spontaneous chronic inflammation or nodular prostate hyperplasia in men. The occurrence of eosinophilic leucocytes was not observed until 3 days after catheter insertion. We cannot see any relation between the reactive stroma cells and mastocytes or with eosinophils.

Key words:
urinary bladder, Foley catheter, polypous cystitis, reactive stromal cells, autopsy.


Sources

1. West, D. A., Cummings, J. M., Longo, W. E. et al.: Role of Chronic Catheterisation in the Development of Bladder Cancer in Patients with Spinal Cord Injury. Urology, 1999, 53, s. 292–297.

2. Delnay, K. M., Stonehill, W. H., Goldman, H. et al.: Bladder Histological Changes Associated with Chronic Indwelling Urinary Catheter. J. Urol., 1999, 161, s. 1106–1108.

3. Anderson, R. U.: Response of Bladder and Urethral Mucosa to Catheterisation. JAMA, 1979, 242, s. 451–453.

4. Ekelund, P., Johansson, S.: Polypoid Cystitis. Acta Pathol. Microbiol. Scand. Sect. A., 1979, 87, s. 79–184.

5. Pitt, M. A., Roberts, I. S. D., Agbamu, D. A. A., Eyden, B. P.: The Nature of Atypical Multinucleated Stromal Cells: A Study of 37 Cases from Different Sites. Histopathology, 1993, 23, s. 137–145.

6. Ekelund, P., Anderstrom, C., Johansson, S. L., Larsson, P.: The Reversibility of Catheter-Associated Polypoid Cystitis. J. Urol., 1983, 130, s. 456–459.

7. Kilic, S., Erguvan, R., Ipek, D. et al.: Polypoid Cystitis Unrelated to Indwelling Catheters. Internat. Urol. Nephrol., 2002, 34, s. 293–297.

8. Milles, G.: Catheter-Induced Hemorrhagic Pseudopolyps of the Urinary Bladder. JAMA, 1965, 19, s. 195–197.

9. Ordónez, N. G., Rosai, J.: In: Rosai J.: Ackerman’s Surgical Pathology. St. Louis, Mosby, 1996, s. 1188.

10. Abdul-Karim, F. W., Cohen, R. E.: Atypical Stromal Cells of Lower Female Genital Tract. Histopathology, 1990, 17, s. 249–253.

11. Groisman, G. M., Polak-Charcon, S.: Fibroepithelial Polyps of the Anus. Am. J. Surg. Pathol., 1998, 22, s. 70–76.

12. Goble, N. M., Clarke, T., Hammonds, J. C.: Histological Changes in the Urinary Bladder Secondary to Urethral Catheterisation. Br. J. Urol. 1989, 63, s. 54 – 357.

Labels
Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management fenix.admin.empty
Login
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account