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Related Experiment Videos

Urolithiasis in enterocystoplasties.

Christopher R J Woodhouse1, William G Robertson

  • 1The Institute of Urology and Nephrology, University College, 48 Riding House Street, London W1W 7EY, UK.

World Journal of Urology
|September 7, 2004
PubMed
Summary
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Urinary stone formation is common after enterocystoplasty, with foreign bodies like staples significantly increasing risk. Metabolic factors and altered urine chemistry contribute to stone development in most patients.

Area of Science:

  • Urology
  • Biochemistry

Background:

  • Enterocystoplasty, a surgical procedure creating an intestinal reservoir for bladder augmentation, is associated with a high incidence of urinary stone formation, ranging from 12% to 52.5%.

Purpose of the Study:

  • To investigate the multifactorial etiology of stone formation in patients with enterocystoplasty.
  • To identify risk factors and metabolic profiles associated with stone development in this patient population.

Main Methods:

  • Review of patient data including stone incidence, surgical factors, and metabolic screening.
  • Analysis of urine chemistry, including pH, citrate, calcium, oxalate, and urate levels.
  • Assessment of the role of foreign bodies and infective agents in stone etiology.

Main Results:

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  • Foreign bodies, such as surgical staples, significantly increase stone formation risk (13% to 43%).
  • Stones are infective in 86% of cases, though 14% are sterile.
  • Metabolic screening reveals that 80% of patients have risk factors for multiple stone types, with universal findings of raised urinary pH (mean 6.93) and hypocitraturia. Hypercalciuria, hyperoxaluria, and hyperuricosuria are present in up to 33%.

Conclusions:

  • Stone formation after enterocystoplasty is multifactorial, influenced by foreign bodies, infection, and metabolic derangements.
  • Altered urinary chemistry, including high pH and low citrate, is prevalent and contributes to stone risk.
  • Comprehensive metabolic evaluation and management strategies are crucial for preventing recurrent stone formation in these patients.