The effect of octreotide, a ling-acting somatostatin analogue, on the reduction of mucosal secretion after ileocystoplasty in rats

Choi, Woong Gyu; Yoon, Moon Soo

Abstract

The use of isolated intestinal segments is currently the best method of augmenling bladder capacity. Pedicled segments of ileum and colon used in lower urinary tract reconstruction retain their normal neurovascular input and might be expected to retain their physiological function despite their new anatomical situation. The mucus secreted mostly by goblet cells in the grafted intestinal mucosa elicits various problems in patient management. This study was attempted to evaluate the effect of octreotide, a long-acting somatostatin analogue on the mucosal secretion. The animals, weighing 250-320gm, were divided into 2 groups: control group, in which only ileocystoplasty was done, and octreotide injection group after ileocystoplasty. Oclreolide was injected daily S.C. 0.002 micrometer/gm after posloperalive 1 week. Cystectomies were performed at postoperative 1. 2, 3, 4 weeks. Histopathologic examination of the ileocystoplasty specimens was done by light microscopy after PAS reaction. 24-hour urine was collected for each rat weekly and then the amount of lyophilized dry mucus in urine was measured. The number of goblet cells within 10(3) micrometer2 of mucosal epithelium in the grafted ileal segments were evaluated by morphometric analysis using an image analyzer. The results were as follows: 1. Microscopically, transitional epithelium extended well over the intestinal mucosa through the anastomotic site at both 4 weeks groups. 2. The amount of urinary lyophilized dry mucus at control group was increased at postoperative 2. 3 weeks (64.2 mg, 67.7 mg) and decreased at 4 weeks (32.7 mg). After octreotide injection, the amount of lyophilized dry mucus significantly decreased when compared with the control group at 2, 3 weeks (15.2 mg, 18.9 mg, p<0.01) 3. The number of goblet cells within 10(3) micrometer2 of mucosal epithelium in control group was increased at 2. 3 weeks after operation (1.94+/-0.31, 2.19+/-0.36) and decreased at 4 weeks (1.61+/-0.25). After octreotide injection. The number of goblel cells significantly decreased when compared with the control group at 2, 3 weeks (1.28+/-0.36, 1.54+/-0.26, p<0.01). These results suggest that octreotide may be effect on the reduction of mucosal secretion after ileocystoplasty. Further investigation using this method will be needed for clinical application.