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Increased urinary nitrosamine excretion in paraplegic patients
A R Tricker1, D J Stickler, J C Chawla
1Institute of Toxicology and Chemotherapy, German Cancer Research Center, Heidelberg, FRG.
Carcinogenesis
|May 1, 1991
Summary
Spine-injured patients with long-term catheters develop bladder cancer risk due to bacteria forming N-nitroso compounds. This study identifies nitrate-reducing bacteria and volatile nitrosamines in urine, suggesting a key risk factor.
Area of Science:
- Urology
- Oncology
- Microbiology
Background:
- Spine-injured patients with long-term urethral catheterization face an increased risk of bladder cancer.
- This complication is often linked to preserving renal function in paraplegic individuals.
Purpose of the Study:
- To investigate the potential etiological factors contributing to bladder cancer in paraplegic patients.
- To determine if bacterial activity in the urinary tract leads to the formation of N-nitroso compounds.
Main Methods:
- Aerobic cultures were performed on urine samples from 30 paraplegic patients.
- Urine samples were analyzed for the presence of volatile nitrosamines and nitrite.
- Bacterial flora, specifically nitrate-reducing organisms, were identified.
Main Results:
- Complex bacterial flora, including nitrate-reducing organisms (e.g., Escherichia coli, Proteus, Klebsiella), were found in 28 of 30 patients.
- Volatile nitrosamines were detected in urine samples from 29 patients.
- Elevated urinary nitrite levels were found in 24 of 30 patients, correlating with N-nitroso compound presence.
Conclusions:
- Bacterially mediated in vivo formation of N-nitroso compounds occurs in the urinary tracts of paraplegic patients.
- These compounds are a potential etiological risk factor for bladder cancer in this patient group.
- Long-term catheterization in spine-injured patients creates an environment conducive to N-nitroso compound formation.