Morphological spectrum of neovaginitis in autologous sigmoid transplant patients

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

AIMS: Autologous intestinal grafts are used to (re)create a vagina in selected patients. The risk of diversion colitis is mentioned as a disadvantage, although its prevalence remains unclear. This study aimed to assess the histopathological characteristics of the sigmoid-derived neovaginal epithelial lining after diverting surgery and correlate these with clinical findings.

METHODS AND RESULTS: Biopsy specimens were obtained from the epithelial lining of the sigmoid-derived neovagina and remaining rectosigmoid as regular follow-up from 26 patients with a median age of 22 years (range 19-52) and median postoperative follow-up of 13 months (range 6-52). Medical history, neovaginal symptoms and sexual activity were documented. An experienced gastrointestinal histopathologist assessed the specimens using a descriptive item-score, comprising signs of chronic and active inflammation. Inflammatory changes were observed in 21 (80.7%) neovaginal and one (3.8%) rectosigmoid specimens. The neovaginal appearance was characterized by an increase of lymphoid aggregates and lymphoplasmacellular infiltrate. Other common features were the presence of polymorphonuclear neutrophils and Paneth cell metaplasia. Neovaginal discharge was correlated with the presence of inflammatory changes (P = 0.008, Spearman's rho = 0.506).

DISCUSSION: Acute and chronic inflammation of the sigmoid-derived neovagina was commonly observed and consistent with a proposed diagnosis of diversion neovaginitis. Neovaginal discharge correlates with this histopathological entity.

Original languageEnglish
Pages (from-to)1004-12
Number of pages9
JournalHistopathology
Volume68
Issue number7
DOIs
Publication statusPublished - Jun 2016

Cite this

@article{7a01cd814bab47838533c6f3fb93b198,
title = "Morphological spectrum of neovaginitis in autologous sigmoid transplant patients",
abstract = "AIMS: Autologous intestinal grafts are used to (re)create a vagina in selected patients. The risk of diversion colitis is mentioned as a disadvantage, although its prevalence remains unclear. This study aimed to assess the histopathological characteristics of the sigmoid-derived neovaginal epithelial lining after diverting surgery and correlate these with clinical findings.METHODS AND RESULTS: Biopsy specimens were obtained from the epithelial lining of the sigmoid-derived neovagina and remaining rectosigmoid as regular follow-up from 26 patients with a median age of 22 years (range 19-52) and median postoperative follow-up of 13 months (range 6-52). Medical history, neovaginal symptoms and sexual activity were documented. An experienced gastrointestinal histopathologist assessed the specimens using a descriptive item-score, comprising signs of chronic and active inflammation. Inflammatory changes were observed in 21 (80.7{\%}) neovaginal and one (3.8{\%}) rectosigmoid specimens. The neovaginal appearance was characterized by an increase of lymphoid aggregates and lymphoplasmacellular infiltrate. Other common features were the presence of polymorphonuclear neutrophils and Paneth cell metaplasia. Neovaginal discharge was correlated with the presence of inflammatory changes (P = 0.008, Spearman's rho = 0.506).DISCUSSION: Acute and chronic inflammation of the sigmoid-derived neovagina was commonly observed and consistent with a proposed diagnosis of diversion neovaginitis. Neovaginal discharge correlates with this histopathological entity.",
keywords = "Journal Article",
author = "{van der Sluis}, {Wouter B} and Neefjes-Borst, {Eskelina A} and Mark-Bram Bouman and Meijerink, {Wilhelmus J H J} and {De Boer}, {Nanne K H} and Mullender, {Margriet G} and {van Bodegraven}, {Adriaan A}",
note = "{\circledC} 2015 John Wiley & Sons Ltd.",
year = "2016",
month = "6",
doi = "10.1111/his.12894",
language = "English",
volume = "68",
pages = "1004--12",
journal = "Histopathology",
issn = "0309-0167",
publisher = "Wiley-Blackwell",
number = "7",

}

Morphological spectrum of neovaginitis in autologous sigmoid transplant patients. / van der Sluis, Wouter B; Neefjes-Borst, Eskelina A; Bouman, Mark-Bram; Meijerink, Wilhelmus J H J; De Boer, Nanne K H; Mullender, Margriet G; van Bodegraven, Adriaan A.

In: Histopathology, Vol. 68, No. 7, 06.2016, p. 1004-12.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Morphological spectrum of neovaginitis in autologous sigmoid transplant patients

AU - van der Sluis, Wouter B

AU - Neefjes-Borst, Eskelina A

AU - Bouman, Mark-Bram

AU - Meijerink, Wilhelmus J H J

AU - De Boer, Nanne K H

AU - Mullender, Margriet G

AU - van Bodegraven, Adriaan A

N1 - © 2015 John Wiley & Sons Ltd.

PY - 2016/6

Y1 - 2016/6

N2 - AIMS: Autologous intestinal grafts are used to (re)create a vagina in selected patients. The risk of diversion colitis is mentioned as a disadvantage, although its prevalence remains unclear. This study aimed to assess the histopathological characteristics of the sigmoid-derived neovaginal epithelial lining after diverting surgery and correlate these with clinical findings.METHODS AND RESULTS: Biopsy specimens were obtained from the epithelial lining of the sigmoid-derived neovagina and remaining rectosigmoid as regular follow-up from 26 patients with a median age of 22 years (range 19-52) and median postoperative follow-up of 13 months (range 6-52). Medical history, neovaginal symptoms and sexual activity were documented. An experienced gastrointestinal histopathologist assessed the specimens using a descriptive item-score, comprising signs of chronic and active inflammation. Inflammatory changes were observed in 21 (80.7%) neovaginal and one (3.8%) rectosigmoid specimens. The neovaginal appearance was characterized by an increase of lymphoid aggregates and lymphoplasmacellular infiltrate. Other common features were the presence of polymorphonuclear neutrophils and Paneth cell metaplasia. Neovaginal discharge was correlated with the presence of inflammatory changes (P = 0.008, Spearman's rho = 0.506).DISCUSSION: Acute and chronic inflammation of the sigmoid-derived neovagina was commonly observed and consistent with a proposed diagnosis of diversion neovaginitis. Neovaginal discharge correlates with this histopathological entity.

AB - AIMS: Autologous intestinal grafts are used to (re)create a vagina in selected patients. The risk of diversion colitis is mentioned as a disadvantage, although its prevalence remains unclear. This study aimed to assess the histopathological characteristics of the sigmoid-derived neovaginal epithelial lining after diverting surgery and correlate these with clinical findings.METHODS AND RESULTS: Biopsy specimens were obtained from the epithelial lining of the sigmoid-derived neovagina and remaining rectosigmoid as regular follow-up from 26 patients with a median age of 22 years (range 19-52) and median postoperative follow-up of 13 months (range 6-52). Medical history, neovaginal symptoms and sexual activity were documented. An experienced gastrointestinal histopathologist assessed the specimens using a descriptive item-score, comprising signs of chronic and active inflammation. Inflammatory changes were observed in 21 (80.7%) neovaginal and one (3.8%) rectosigmoid specimens. The neovaginal appearance was characterized by an increase of lymphoid aggregates and lymphoplasmacellular infiltrate. Other common features were the presence of polymorphonuclear neutrophils and Paneth cell metaplasia. Neovaginal discharge was correlated with the presence of inflammatory changes (P = 0.008, Spearman's rho = 0.506).DISCUSSION: Acute and chronic inflammation of the sigmoid-derived neovagina was commonly observed and consistent with a proposed diagnosis of diversion neovaginitis. Neovaginal discharge correlates with this histopathological entity.

KW - Journal Article

U2 - 10.1111/his.12894

DO - 10.1111/his.12894

M3 - Article

VL - 68

SP - 1004

EP - 1012

JO - Histopathology

JF - Histopathology

SN - 0309-0167

IS - 7

ER -