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Metabolic consequences after urinary diversion.

Raimund Stein1, Peter Rubenwolf1

  • 1Division of Pediatric Urology, Department of Urology, Mainz University Medical Center, Johannes Gutenberg University , Mainz , Germany.

Frontiers in Pediatrics
|March 22, 2014
PubMed
Summary
This summary is machine-generated.

Urinary diversion using bowel segments can cause metabolic issues, like acidosis, vitamin B12 malabsorption, and bile acid issues. Early alkali treatment and careful follow-up prevent serious complications.

Keywords:
acidosisdiarrheametabolic complicationsurinary diversionvitamin B12

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Area of Science:

  • Urology
  • Gastroenterology
  • Nephrology

Background:

  • Urinary diversion (UD) using bowel segments can lead to metabolic disturbances.
  • While subclinical issues are common, severe complications are rare.
  • Bowel segments retain some absorptive/secretory functions when exposed to urine.

Purpose of the Study:

  • To review the metabolic consequences of using bowel segments for urinary diversion.
  • To highlight the importance of early detection and prevention of complications.

Main Methods:

  • Literature review of studies on metabolic sequelae of urinary diversion.
  • Analysis of complications associated with specific bowel segments (ileum, colon).

Main Results:

  • Ileal/colonic segments can cause hyperchloremic metabolic acidosis, preventable with alkali supplementation.
  • Ileal resection may lead to vitamin B12 and bile acid malabsorption, causing neurological/hematological issues.
  • Bowel habit changes can occur.

Conclusions:

  • Careful patient and procedure selection are crucial for urinary diversion.
  • Long-term monitoring and prophylactic treatment of acidosis are essential.
  • Preventing metabolic complications requires a proactive approach.