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Risk of Bone Fractures Following Urinary Intestinal Diversion: A Population Based Study.

Patrick O Richard1, Shaheena Bashir2, Bruno D Riverin1

  • 1Division of Urology, Departments of Surgery, Centre Hospitalier Universitaire de Sherbrooke and Centre de Recherche du CHUS , Sherbrooke , Quebec , Canada.

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|March 14, 2019
PubMed
Summary
This summary is machine-generated.

Patients undergoing intestinal urinary diversion face a higher risk of bone fractures. This study confirms the increased fracture risk, emphasizing the need for bone health monitoring in these individuals.

Keywords:
acidosisbonecystectomyfracturesurinary bladder neoplasmsurinary diversion

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Area of Science:

  • Urology
  • Oncology
  • Bone Metabolism

Background:

  • Intestinal urinary diversion is a surgical procedure used in patients with bladder cancer and other conditions.
  • A potential complication is an increased risk of bone fractures, possibly linked to chronic metabolic acidosis and bone loss.

Purpose of the Study:

  • To evaluate whether patients who have undergone intestinal urinary diversion are at a significantly increased risk for bone fractures.
  • To compare fracture incidence rates between patients with diversion and matched control groups.

Main Methods:

  • A retrospective cohort study using linked administrative databases in Ontario, Canada (1994-2014).
  • Identified patients who underwent intestinal urinary diversion for bladder cancer or non-bladder cancer causes.
  • Matched patients 4:1 to a healthy control cohort and analyzed fracture incidence rates and fracture-free survival using multivariable Cox proportional hazards models.

Main Results:

  • A total of 4,301 patients with diversion (bladder cancer) and 907 without (non-bladder cancer) were analyzed.
  • Fracture incidence rates were significantly higher in both diversion cohorts (4.41 and 5.67 fractures/100 person-years) compared to controls (2.63 and 3.51 fractures/100 person-years, respectively; p <0.001).
  • Multivariable analysis showed a significantly increased risk of fracture for patients with intestinal urinary diversion (HR 1.48 for both groups).

Conclusions:

  • Patients with intestinal urinary diversion, irrespective of the reason (bladder cancer or other), have an elevated risk of bone fractures.
  • These findings align with previous research and underscore the importance of proactive bone health monitoring in this patient population.