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A review of metabolic consequences and long-term complications of enterocystoplasty in children

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Abstract

This review summarizes the important metabolic consequences and long-term complications associated with enterocystoplasty, with a particular emphasis on the pediatric patient with genitourinary abnormalities. A directed MEDLINE literature review for metabolic and long-term complications following enterocystoplasty was performed. Information gained through published literature and from our database was reviewed and summarized to provide the reader with a thorough review of the subject. Bowel is not a perfect tissue for substitution or augmentation, and its use to treat functionally and structurally compromised bladders is associated with several metabolic consequences and long-term complications. Metabolic acidosis is the most common metabolic abnormality seen. The rates and severity of these complications vary, though they may have a profound impact on a patient’s quality of life after enterocystoplasty. The metabolic consequences and long-term complications associated with enterocystoplasty are important clinical features of this intervention, and careful consideration should be given to them before pursuing enterocystoplasty.

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References and Recommended Reading

  1. Duckett JW, Gazak JM: Complications of ureterosigmoidostomy. Urol Clin North Am 1983, 10:473–481.

    PubMed  CAS  Google Scholar 

  2. Koch MO, McDougal WS, Thomson CO: Mechanisms of solute transport following urinary diversion through intestinal segments: an experimental study with rats. J Urol 1991, 146:1390–1397.

    PubMed  CAS  Google Scholar 

  3. Poulsen AL, Steven K: Acid-base metabolism following bladder substitution with the ileal urethral Kock reservoir. Br J Urol 1996, 78:47–53.

    PubMed  CAS  Google Scholar 

  4. Body JD: Chronic acidosis secondary to ureteral reimplantation. Am J Dis Child 1931, 42:366–371.

    Google Scholar 

  5. Akerlund S, Forssell-Aronsson E, Jonsson O, Kock NG: Decreased absorption of 22Na and 36CL in ileal reservoirs after exposure to urine. An experimental study in patients with continent ileal reservoirs for urinary or fecal diversion. Urol Res 1991, 19:249–252.

    Article  PubMed  CAS  Google Scholar 

  6. Hall MC, Koch MO, Halter SA, Dahlstedt SM: Morphologic and functional alterations of intestinal segments following urinary diversion. J Urol 1993, 149:664–666.

    PubMed  CAS  Google Scholar 

  7. Deane AM, Woodhouse CR, Parkinson MC: Histological changes in ileal conduits. J Urol 1984, 132:1108–1101.

    PubMed  CAS  Google Scholar 

  8. Akerlund S, Jagenburg R, Kock NG, Philipson BM: Absorption of L-phenylalanine in human ileal reservoirs exposed to urine. Urol Res 1988, 16:321–333.

    Article  PubMed  CAS  Google Scholar 

  9. Mtchell ME, Piser JA: Intestinocystoplasty and total bladder replacement in children and young adults: Follow-up in 129 cases. J Urol 1987, 138:579–584.

    Google Scholar 

  10. Castro JE, Ram MD: Electrolyte imbalance following ileal urinary diversion. Br J Urol 1970; 42:29–32.

    PubMed  CAS  Google Scholar 

  11. Malek RS, Burke EC, DeWeerd JH: Ileal conduit urinary diversion in children. J Urol 1971, 105:892–900.

    PubMed  CAS  Google Scholar 

  12. Whitmore WF III, Gittes RF: Reconstruction of the urinary tract by cecal and ileocecal cystoplasty: review of a 15 year experience. J Urol 1983, 129:494–498.

    PubMed  Google Scholar 

  13. McDougal WS: Metabolic complications or urinary intestinal diversion. J Urol 1992, 147:1199–1207.

    PubMed  CAS  Google Scholar 

  14. Koch MO, McDougal WS: Chlorpromazine: adjuvant therapy for metabolic degrangements created by urinary diversion through intestinal segments. J Urol 1985, 134:165–169.

    PubMed  CAS  Google Scholar 

  15. Koch MO, McDougal WS: Nicotinic acid: treatment for the hyperchloremic acidosis following urinary diversion through intestinal segments. J Urol 1985, 134:162–164.

    PubMed  CAS  Google Scholar 

  16. Koch MO, Gurevitch E, Hill DE, McDougal WS: Urinary solute transport by intestinal segments: a comparative study of ileum and colon in rats. J Urol 1990, 143:1275–1279.

    PubMed  CAS  Google Scholar 

  17. Geist RW, Ansell JS: Total body potassium in patients after ureteroileosotomy. Surg Gynecol Obstet 1961, 113:585–590.

    PubMed  CAS  Google Scholar 

  18. Mills RD, Studer UE: Metabolic consequences of continent urinary diversion. J Urol 1999, 161:1057–1066.

    Article  PubMed  CAS  Google Scholar 

  19. Adams MC, Mitchell ME, Rink RC: Gastrocystoplasty: an alternative solution to the problem of urological reconstruction in the severely compromised patient. J Urol 1988, 140:1152–1156.

    PubMed  CAS  Google Scholar 

  20. Gosalbez R Jr, Woodard JR, Broecker BH, Warshaw B: Metabolic complications of the use of stomach for urinary reconstruction. J Urol 1993, 150:710–712.

    PubMed  Google Scholar 

  21. Plawker MW, Rabinowitz SS, Etwaru DJ, Glassberg KI: Hypergastrinemia, dysuria-hematuria and metabolic acidosis: complications associated with gastrocystoplasty. J Urol 1995, 154:546–549.

    Article  PubMed  CAS  Google Scholar 

  22. Nguyen DH, Bain MA, Salmonson KL, et al.: The syndrome of dysuria and hematuria in pediatric urinary reconstruction with stomach. J Urol 1993, 150:707–709.

    PubMed  CAS  Google Scholar 

  23. Golimbu M, Morales P: Jejunal conduits: techniques and complications. J Urol 1975, 113:787–795.

    PubMed  CAS  Google Scholar 

  24. Bonnheim DC, Petrelli NJ, Steinberg A, Mittelman A: The pathophysiology of the jejunal conduit syndrome and its exacerbation by parenteral hyperalimentation. J Surg Oncol 1984, 26:172–175.

    Article  PubMed  CAS  Google Scholar 

  25. Klein EA, Montie JE, Montague DK, Kay R, Straffon RA: Jejunal conduit urinary diversion. J Urol 1986, 135:244–246.

    PubMed  CAS  Google Scholar 

  26. Fontaine E, Barthelemy Y, Houglatte A, et al.: Twenty-year experience with jejunal conduits. Urology 1997, 50:207–213.

    Article  PubMed  CAS  Google Scholar 

  27. Fountaine E, Leaver R, Woodhouse CRJ: The effects of intestinal urinary reservoirs on renal function: a 10-year follow-up. Br J Urol Int, 2000, 86:195–198.

    Google Scholar 

  28. Jonsson O, Olofsson G, Lindholm E, Törnqvist H: Long-term experience with the Kock ileal reservoir for continent urinary diversion. Eur Urol 2001, 40:632–640.

    Article  PubMed  CAS  Google Scholar 

  29. Kaveggia FF, Thompson JS, Schafer EC, et al.: Hyperammonemic encephalopathy in urinary diversion with urea-splitting urinary tract infection. Arch Intern Med 1990, 150:2389–2392.

    Article  PubMed  CAS  Google Scholar 

  30. Matsui U, Topoll B, Miller K, Hautmann RE: Metabolic long-term follow-up of the ileal neobladder. Eur Urol 1993, 24:197–200.

    PubMed  CAS  Google Scholar 

  31. Pannek J, Haupt G, Schulze H, Senge T: Influence of continent ileal urinary diversion on vitamin B12 absorption. J Urol 1996, 155:1206–1208.

    Article  PubMed  CAS  Google Scholar 

  32. Hoffman AF: Bile acid malabsorption caused by ileal resection. Arch Intern Med 1972, 130:597–605.

    Article  Google Scholar 

  33. Durrans D, Wujanto R, Carroll RN, Torrance HB: Bile acid malabsorption: a complication of ileal conduit surgery. Br J Urol 1989, 64:485–488.

    PubMed  CAS  Google Scholar 

  34. Singleton AO, Redmond DC, McMurray JE: Ileocecal resection and small bowel transit and absorption. Ann Surg 1964, 159:690–694.

    Article  PubMed  Google Scholar 

  35. Weise ES, Fleischmann A, Studor UE: Persistent hypertriglyceridemia in patients after construction of a low pressure ileal orthotopic reservoir. J Urol 1997, 157:238.

    Google Scholar 

  36. Kirsch AJ, Hensle TW: Symptomatic cholelithiasis following continent urinary diversion using ileocolonic bowel segments. J Urol 1994, 151:859–860.

    PubMed  CAS  Google Scholar 

  37. Bushinsky DA, Krieger NS, Geisser DI, et al.: Effects of pH on bone calcium and proton fluxes in vitro. Am J Physiol 1983, 245:204–209.

    Google Scholar 

  38. Lee SW, Russell J, Avioli LV: 25-hydroxycholecalciferol to 1,25-dihydroxycholecalciferol: conversion impaired by systemic metabolic acidosis. Science 1977, 195:994–996.

    Article  PubMed  CAS  Google Scholar 

  39. Arnett TR, Dempster DW: Effects of pH on bone resorption by rat osteoclasts in vitro. ENDO 1986, 119:119–124.

    CAS  Google Scholar 

  40. McDougal WS, Koch MO: Effect of sulfate on calcium and magnesium homeostasis following urinary diversion. Kidney Int 1989, 35:105–115.

    Article  PubMed  CAS  Google Scholar 

  41. Siklos P, Davie M, Jung RT, Chalmers TM: Osteomalacia in ureterosigmoidostomy: healing by correction of the acidosis. Br J Urol 1980, 52:61–62.

    Article  PubMed  CAS  Google Scholar 

  42. Perry W, Allen LN, Stamp TC, Walker PG: Vitamin D resistance in osteomalacia after ureterosigmoidostomy. N Engl J Med 1977, 297:1110–1112.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Division of Pediatric Urology, Children’s Hospital of New York, Columbia University Medical Center, New York-Presbyterian Hospital, 3959 Broadway, 219 N., New York, NY, 10032, USA

    Terry W. Hensle

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  1. Terry W. Hensle
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  2. Scott M. Gilbert
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Correspondence to Terry W. Hensle.

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Hensle, T.W., Gilbert, S.M. A review of metabolic consequences and long-term complications of enterocystoplasty in children. Curr Urol Rep 8, 157–162 (2007). https://doi.org/10.1007/s11934-007-0066-9

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  • DOI: https://doi.org/10.1007/s11934-007-0066-9

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