I had my annual my pouchoscopy last Friday and Dr Shen stated that my pouch looked really good. He took biopsies as normal and results show everything good except this, " rectal cuff biopsy, villiform intestinal mucosa with focal active inflammation , negative for granulomas or dysplasia. ".
I was under the assumption when getting a pouch redo with mucousectomy , that you either don't have a cuff any longer or cannot get cuff inflammation??
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My mistake. Cuff is still there after mucousectomy they just strip the lining. I heard back from Dr Shen and said he only treats by endoscopic finding , which mine looked good, and not biopsy inflammation findings. So no treatment as of now.
also, if rectal cuff tissue can grow back, why do they even risk doing a mucousectomy with the incontinence risks?
While it may grow back, it is not likely. This is particularly true with a skilled surgeon.
Jan 
although Shen did not see inflammation in my cuff via the pouchoscopy, it showed mild inflammation on the biopsy report. Shen stated it is possible the tissue has grown back after the mucosectomy. Dr Remzi did my redo and it hasn't even been 2 years since the surgery, I would say hes a skilled surgeon, but can it grow back that quickly??
Well, it could just be some patchy growth, not the entire mucosa that was stripped. The main point is that the clinical assessment from the visualization is that it is fine. Every pouch and every cuff will show microscopic inflammation on the path report. This is why they always note something to the effect of "clinical correlation recommended." The pathologist is just reporting what is seen on the cellular level. He is not the clinition.
This is why I like to remain awake during scopes. That way I see what my doc sees and I can ask questions on the spot.
Jan
that's what I always thought, that all pouches have some type of inflammation. But the biopsies only showed inflammation in the cuff, but none in the pouch itself. As long as I am not having issues and the scope showed all good I wont even care about it. just interesting
