Metabolic Complications of the use of Stomach for Urinary Reconstruction

Gosálbez, Rafael; Woodard, John R.; Broecker, Bruce H.; Warshaw, Barry L.

doi:10.1016/s0022-5347(17)35594-5

Cited by 98 publications

(27 citation statements)

References 11 publications

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“…The reported benefits of gastrocystoplasty over intestinal segment augmentation include reduced chloride reabsorption and net chloride excretion by the gastric mucosa, decreased mucus production, decreased urinary infection in the presence of acid urine, ease of uretheric reimplantation and good compliance due to the thick muscular layers of the gastric wall [4,15]. But in children undergoing gastrocystoplasty, some complica-32 tions, such as hematuria and dysuria syndrome and hypochloremic metabolic alkalosis, may be identified [7,14]. Gosalbez et al [6] reported severe hypochloremic hypokalemic metabolic alkalosis associated with hypergastrinemia refractory to medical treatment in 2 of 30 patients who underwent gastrocystoplasty.…”

Section: Discussionmentioning

confidence: 99%

Reversed seromuscular gastrocystoplasty for bladder augmentation

Abasiyanik¹,

Dasci

Duman

et al. 1999

Res. Exp. Med.

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The aim of this study was to prevent the complications of gastrocystoplasty by using reversed seromuscular gastrocystoplasty for bladder augmentation. Healthy mongrel dogs were used in the study. A diamond shaped segment was separated from the remainder of the stomach preserving the right gastroepiploic artery in 11 dogs. The gastric mucosa was removed. A reversed seromuscular gastrocystoplasty was performed. The animals were observed for a mean of 7.7 months. Thereafter, relaparotomy was performed in all animals. A bladder stone was found in 1 dog. In the histopathological evaluation of the urinary bladder, it was seen that the gastric serosal surface was covered with the urothelium in all dogs. Transitional epithelial hyperplasia in 1 dog (12.5%) and squamous metaplasia in 2 dogs (25%) were identified. There were no statistical differences between preoperative and postoperative values of urine and blood pH and serum sodium, potassium, chloride, and bicarbonate levels. Complications of gastrocystoplasty such as hypochloremic metabolic alkalosis and hematuria and dysuria syndrome, are prevented by this procedure. The shrinkage of the gastric patch surface may also be prevented by facing the smooth gastric serosa to the internal surface of the urinary bladder.

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Section: Discussionmentioning

confidence: 99%

Reversed seromuscular gastrocystoplasty for bladder augmentation

Abasiyanik¹,

Dasci

Duman

et al. 1999

Res. Exp. Med.

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“…These vary depending on the type of gastro-intestinal segment used [1][2][3]. Due to the risks of metabolic disturbances and other potential complications, patients need long and continuous followup and care [4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Quality of life: urinary bladder augmentation or substitution in children

et al. 2009

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“…When jejunal part is utilized hyponatremia can appear with hypochloremic acidosis. When ileum or colon is used hypokalemia with coexisting acidosis is typical [5,31,32].…”

Section: Acid-base and Ions Imbalancementioning

confidence: 99%

Urinary Diversion Metabolic Complications – Underestimated Problem

Krajewski¹,

Piszczek²,

Krajewska³

et al. 2014

Adv Clin Exp Med

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Bladder cancer is one of the most frequent human cancers. In 2011 more than six thousand people in Poland developed BC and more than three thousand died because of it. Treatment of bladder cancer depends on its stage. In less advanced tumours (Ta, Tcis, T1) transurethral resection of bladder tumor with adjuvant immunotherapy is often therapeutic. In more advanced cases (≥ T2) radical cystectomy is needed. There are several surgical types of postcystectomy urinary diversion divided into two fundamental types -enabling and not enabling urine continence. The most common procedures include ureterocutaneostomy, ileal or colon conduit, orthopic ileal bladder, heterotopic continent bladder replacement (pouch) and urinary diversion via the rectum. Depending on type of cystectomy, various metabolic complications occur, because the absorptive-secretory function of used bowel segment is intact. Complications include bowel dysfunction, malabsorption of various vitamins, acid-base imbalance, electrolyte imbalance, abnormalities in bone metabolism, formation of renal calculi, secondary malignancies and disturbances in function of kidneys or liver. Early diagnosed complications can be treated easier, recognised in advanced stages are often irreversible. In our paper we present review of different approaches to bladder cancer treatment and metabolic complications occurring after these procedures (Adv Clin Exp Med 2014, 23, 4, 633-638). Bladder cancer (BC) is one of the most frequent human cancers. In 2011 more than six thousand people in Poland developed BC and more than three thousand died because of it. In terms of morbidity in 2011 it was the fifth in male and fifteenth in female cancer in Poland [1]. Frequently, the sole symptom of BC is microscopic or macroscopic haematuria, without any pain or urinary disorders. Other possible symptoms like polyuria or urinary urgency can indicate carcinoma in situ. However, palpable tumor in abdomen, bone pain or weight loss can identify advanced and metastatic cancer.Incidence and prevalence of BC increase with age and exposure to environmental toxins like cigarette smoke. It is proven that smokers have 2 to 6 times grater chance of BC development [2]. Male gender, inflammation, chronic infection of bladder and previous radiotherapy are other predisposing factors.The most common histological type of BC is urothelial cancer. Staging of BC is based on invasion of bladder wall, and is described within TNM (tumor, nodes, metastases) system. Treatment of BC depends on its stage. From a clinical point of view, the most important division is one, which splits into noninfiltrating lamina muscularis tumours (Ta, Tcis, T1) and those infiltrating lamina muscularis (≥ T2). In the first group the procedure of choice is TURB (transurethral resection of bladder tumor), which is diagnostic and often therapeutic. If TURB procedure is insufficient, according to staging and clinical situation, re-TURB or adjuvant immunotherapy can be introduced. In tumours with muscular invasion the method of choi...

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Metabolic Complications of the use of Stomach for Urinary Reconstruction

Cited by 98 publications

References 11 publications

Reversed seromuscular gastrocystoplasty for bladder augmentation

Reversed seromuscular gastrocystoplasty for bladder augmentation

Quality of life: urinary bladder augmentation or substitution in children

Urinary Diversion Metabolic Complications – Underestimated Problem

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