Enterocystoplasty: The long-term effects on bone mineral density

Area of Science:

• Urology
• Pediatric Surgery
• Metabolic Bone Disease

Background:

• Enterocystoplasty is associated with decreased bone mineral density (BMD).
• Long-term effects of enterocystoplasty on BMD require further investigation.
• Identifying patients at risk for osteopenia and osteoporosis post-enterocystoplasty is crucial for fracture prevention.

Purpose of the Study:

• To investigate the long-term impact of enterocystoplasty on bone mineral density (BMD).
• To identify patients with osteopenia and osteoporosis following enterocystoplasty.
• To assess the relationship between enterocystoplasty, BMD, and fracture risk.

Main Methods:

• Retrospective review of 24 patients who underwent enterocystoplasty for non-neurogenic reasons with >15 years follow-up.
• Comparison with a control group of 10 individuals who underwent primary bladder exstrophy closure without enterocystoplasty.
• Dual-energy X-ray absorptiometry (DEXA) scans used to determine BMD and T- and Z-scores.

Main Results:

• Eleven of 24 patients (46%) had normal BMD.
• Seven patients (29%) showed osteopenia, indicating increased fracture risk.
• Six patients (25%) had osteoporosis, with three also having reduced glomerular filtration rate (GFR).
• Eight of 10 controls (80%) had normal BMD.

Conclusions:

• Childhood enterocystoplasty can lead to significant bone mineral density loss.
• BMD reduction is more pronounced in patients with additional risk factors, such as reduced GFR.
• Early identification of BMD loss allows for intervention to prevent osteoporosis and pathological fractures.