Factors causing variation in urinary N‐nitrosamine levels in enterocystoplasties

Abstract

Objective To establish the presence or absence of any diurnal or long-term variation in N-nitrosamine levels (which might be important in the development of cancer in enterocystoplasties) in enterocystoplasty urine, and to assess other factors that might alter enterocystoplasty N-nitrosamine levels. Patients, subjects and methods Thirty-six patients with enterocystoplasties and six normal controls were assessed. Urine samples were collected every 4 h over a 24-h period and N-nitrosamine levels determined using a modi®cation of the Pignatelli method. An additional urine sample was assessed by microscopy, culture and sensitivity. In a subgroup of 16 patients with an enterocystoplasty, the urinary N-nitrosamine levels were re-measured at 3-monthly intervals. Results No diurnal or long-term variation in urinary N-nitrosamine levels was identi®ed. The mean N-nitrosamine levels were signi®cantly higher in the cystoplasty group than in the controls (1.7 vs 1.0 mmol/L; P=0.008). Mean N-nitrosamine levels were also signi®cantly higher in enterocystoplasty patients with sterile pyuria than in those with no pyuria (P=0.01). Those taking prophylactic antibiotics had signi®cantly lower mean N-nitrosamine levels than those not doing so (P=0.05). Individuals with infected urine and those needing to intermittently catheterize had higher N-nitrosamine levels than their counterparts, but this difference was not signi®cant. Conclusion There were no diurnal or long-term variations in urinary N-nitrosamine levels. Levels were consistently higher in patients with in¯amed or infected cystoplasties, those using intermittent selfcatheterization and those not taking antibiotic prophylaxis.

Organ-specific matrix self-assembled by mesenchymal cells improves the normal urothelial differentiation in vitro

“…Like native bladder, cytokeratin 14 immunolabeling was not observed in our VM, which indicate the conformity of the development sequence taken by BUC under the influence of the BMC's matrix. the gold standard treatment (enterocystoplasty) is associated with well-known complications [1][2][3][4]. The tissue engineering field recently made great progresses to optimize the methods involved in urological tissue regeneration in vitro.…”

Routine surveillance cystoscopy for patients with augmentation and substitution cystoplasty for benign urological conditions: is it necessary?

“…Increased N‐nitrosamine levels from catalysation of urinary nitrate by the normal fecal bacteria or bacteria occurring in infected urine [14,15] and or increased free oxygen radicals produced by activated phagocytes during an inflammatory response (such as that occurs at the suture line between the urothelium and colonic mucosa [16]) have been implicated in the pathogenesis of these tumours. Several reported cases have been in patients who were augmented for small contracted post‐tuberculous or post‐schistosomiasis bladders.…”

Evolution in Tissue Engineering for the Lower Urinary Tract

“…Thus, the incorporation of these various native tissues involves metabolic imbalances specific to each one, as well as the formation of mucus and urolithiases, which are significant morbidity factors (Mundy & Nurse 1992, McDougal 1992. Its addition to the biochemical profiles of mucous membranes used, the bad contact with the toxic urine leads to risks of neoplasic transformation of the native substitutes (Woodhams et al 2001, Ali-El-Dein et al 2002, as well as structural deterioration of alloplastic substitutes (Cross et al 2003). The incorporation of intestinal segments previously de-epithelialized was attempted to avoid mucus production and potential reabsorption within an animal model but it lead to fibrosis, and then, the contraction of the graft because of the urine being in direct contact with the underlying submucosa and extracellular matrix (Hafez et al 2005).…”