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Ileal bladder augmentation and vitamin B12: levels decrease with time after surgery
S C Blackburn1, S Parkar, M Prime
1Department of Urology, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK.
Insights
Vitamin B12 deficiency can occur after ileocystoplasty in children. Long-term monitoring of vitamin B12 levels is recommended for these patients.
Area of Science:
- Pediatric Surgery
- Urology
- Nutritional Science
Background:
- Ileocystoplasty is a surgical procedure used in pediatric urology.
- Potential long-term complications, such as vitamin B12 deficiency, require investigation.
Purpose of the Study:
- To investigate the incidence and progression of vitamin B12 deficiency in children following ileocystoplasty.
- To identify factors associated with vitamin B12 levels in this patient cohort.
Main Methods:
- Retrospective analysis of serum vitamin B12 levels in 105 children who underwent ileocystoplasty.
- Correlation of vitamin B12 levels with time since surgery and length of the ileal segment preserved.
Main Results:
- Two patients (1.9%) were diagnosed with vitamin B12 deficiency, both over 7 years post-surgery.
- A significant negative correlation was observed between serum vitamin B12 levels and duration of follow-up (P < 0.01).
- Patients preserving a longer ileal segment (>60 cm) showed a trend towards higher vitamin B12 levels, though not statistically significant.
Conclusions:
- Serum vitamin B12 levels tend to decrease over time after ileocystoplasty.
- Long-term surveillance of vitamin B12 status is crucial for children who have undergone this procedure.
Objective:
We investigated vitamin B12 deficiency following ileocystoplasty in children.
Methods:
Patients who underwent ileocystoplasty between December 1993 and September 2006 were included and B12 levels were retrospectively analysed. Patients with a serum B12 of less than 150 pg/ml were considered deficient. The distance of the ileal segment from the ileocaecal valve was recorded.
Results:
There were 105 patients in the series; 61 were male. Mean age at surgery was 7.7 years (SD = 3.9). The mean interval from surgery to most recent B12 level was 50 months (SD = 30). None of the patients were on B12 supplementation. Two patients were B12 deficient, both more than 7 years after surgery; 44% of patients with levels available 7 years after surgery had a B12 below 300 pg/ml. There was a significant negative correlation between B12 level and length of follow up (Spearman's rank, P < 0.01). Twenty patients with an ileal segment sparing 60 cm from the ileocaecal valve had a higher mean B12 (524 vs 419, SEM 60 vs 28). This was not statistically significant.
Conclusion:
We demonstrate a reduction in serum B12 level with time following ileocystoplasty. These patients should have their B12 levels measured in the long term.
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