Urothelial Differences in the Exstrophy-Epispadias Complex: Potential Implications for Management.
Publication/Presentation Date
5-1-2021
Abstract
PURPOSE: The authors examined the urothelium of exstrophy-epispadias complex spectrum patients for histological differences and expression of terminal markers of urothelial differentiation.
MATERIALS AND METHODS: Between 2012 and 2017 bladder biopsies were obtained from 69 pediatric exstrophy-epispadias complex patients. These specimens were compared to bladder specimens from normal controls. All bladder specimens underwent histological assessment followed by immunohistochemical staining for uroplakin-II and p63. Expression levels of uroplakin-II and p63 were then assessed by a blinded pathologist.
RESULTS: Forty-three classic bladder exstrophy biopsies were obtained (10 newborn closures, 22 delayed closures, and 11 repeat closures). Additional biopsies from 18 cloacal exstrophy patients and 8 epispadias patients were also evaluated. These specimens were compared to 8 normal control bladder specimens. Overall, uroplakin-II expression was lower in exstrophy-epispadias complex patients compared to controls (p
CONCLUSIONS: The urothelium in the exstrophy-epispadias complex bladder is strikingly different than that of healthy controls. Uroplakin-II expression is greatly reduced in exstrophy-epispadias complex bladders and is influenced by the timing of bladder closure. Reduced uroplakin-II expression and increased rates of squamous metaplasia in exstrophy-epispadias complex patients undergoing delayed closure suggests that exposure of the urothelium may induce these changes. These findings shed light on the molecular changes in exstrophy-epispadias complex bladders and may have implications on the appropriate timing of primary bladder closure, as those closed in the newborn period appear to have a greater potential for growth and differentiation.
Volume
205
Issue
5
First Page
1460
Last Page
1465
ISSN
1527-3792
Published In/Presented At
Kasprenski, M., Michaud, J., Yang, Z., Maruf, M., Benz, K., Jayman, J., Epstein, J., Di Carlo, H., & Gearhart, J. P. (2021). Urothelial Differences in the Exstrophy-Epispadias Complex: Potential Implications for Management. The Journal of urology, 205(5), 1460–1465. https://doi.org/10.1097/JU.0000000000001510
Disciplines
Life Sciences | Medicine and Health Sciences
PubMedID
33347773
Department(s)
Department of Pathology and Laboratory Medicine
Document Type
Article