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Related Experiment Videos

Bladder, bowel and bones--skeletal changes after intestinal urinary diversion.

Alexander Roosen1, Elmar W Gerharz, Stefan Roth

  • 1Department of Urology, Bavarian Julius Maximilians University Medical School, Josef Schneider Strasse 2, 97080 Würzburg, Germany. Roosen_A@klinik.uni-wuerzburg.de

World Journal of Urology
|August 19, 2004
PubMed
Summary

Urinary diversion using intestinal segments rarely causes bone metabolism issues in adults. Careful monitoring is advised for children and those with impaired kidney function.

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Area of Science:

  • Urology
  • Metabolic Bone Disease

Background:

  • Urinary diversion via intestinal segments raises theoretical concerns for impaired bone metabolism.
  • The clinical relevance of acidosis and malabsorption in this context remains debated.

Purpose of the Study:

  • To evaluate the clinical relevance of impaired bone metabolism after intestinal urinary diversion.
  • To assess the incidence of metabolic bone disease in patients with intestinal urinary reservoirs.

Main Methods:

  • Review of contemporary case series on urinary diversion.
  • Analysis of acid-base balance, osteotropic serum parameters, calcium, and phosphate levels.

Main Results:

  • Overt derangements like rickets or osteomalacia were rarely observed.

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  • No consistent changes in osteotropic serum parameters were found; calcium and phosphate levels remained normal.
  • Clinical data did not confirm a higher risk of metabolic bone disease with colonic reservoirs.

    • Conclusions:

    • Impaired bone metabolism is not a significant clinical concern in most adults after intestinal urinary diversion.
    • Early correction of base excess may obscure the natural history of bone metabolism.
    • Bone-specific follow-up is unnecessary for asymptomatic adults with normal acid-base balance; children and patients with renal impairment require attention.