An Experimental Study on Relationship Between Cystitis Glandularis and Vesico-Rectal Fistulas

Park, Yong Hwa

Abstract

An experimental study on cystitis glandularis induced by vesico-rectal fistula formation in rabbit was performed, to analyze relationship between histopathologic complexity of cystitis glandularis 3rd various forms of chronic proliferative cystitis, and to evaluate the possibility that contiguous endovesical growth of intestinal mucosa through fistulous tract may partly participate in the pathogenesis of cystitis glandularis. Followings were the results: 1) Various types and stages of chronic proliferative cystitis including cystitis glandularis were de. monstrable. 2) 51.5% of animals disclosed cystitis glandularis, of both intestinal and subtrigonal types with increasing frequency and severity roughly parallel to experimental duration. Minimum requirement of duration for development was approximately 3 months. 3) Among the cases with cystitis glandularis, intestinal type comprised 52. 9% mainly affecting trigonal regions, whereas subtrigonal type of 17.6% was encountered in the bladder neck. Rest of cases interpreted as mixed type, containing both intestinal and subtrigonal varieties. 4) More than two third of cases with cystitis glandularis accompanied nests of von Brunn, cystitis cystica, squamous metaplasia and small proportion of cystitis follicularis and bullosa, with indications of development of glandular structures followed by chronic non-specific cystitis, formation of von Brunn's cell nests with central liquefaction and glandular metaplasia in order of sequence. 5) Unusually high incidence of intestinal type of cystitis glandularis in the trigonal regions could partly be explained by endocystic contiguous extension or ectopic proliferation of intestinal glands through the fistulous tract. From the above experimental design, cystitis glandularis may develop not only following consequent metaplastic mechanism but also secondary to intravesical extension of colonic mucosa through the fistulous tract. None of cases showed invasive neoplastic growth, though cellular atypism was encountered only in three instances.