[Ileocystoplasty and enteropathies].
The formation of a neobladder by the transformation of sections of the terminal ileum has become an important alternative to supravesical urinary diversion. The discussion about the optimal urosurgical technique however has, so far ignored the problems of consecutive enteric defunctionalization and deficiency symptoms resulting from the anatomical shortening of the ileum. The analysis of experimental investigations and functionally comparable syndromes, such as Crohn's disease, permits an insight into the pathophysiological consequences. These relate to disorders in the bile acid and vitamin B12 metabolism and to the potential induction of a secondary hyperoxaluria, with a subsequent oxalate calculus diathesis. Further more, the reduction of the absorption area in the ileum can lead to calcium and vitamin D malabsorption with the development of intestinal osteopathy. These pathophysiological relationships must be taken into account in the long-term medical care of patients with ileal neobladder. The preventive and therapeutic measures are described.
Urologische Klinik, Krankenanstalten Düren, Akademisches Lehrkrankenhaus.
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S
Roth
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Rathert
D002118:Calcium / Q000172:deficiency; D002769:Cholelithiasis / Q000209:etiology; D005260:Female; D006474:Hemorrhagic Disorders / Q000209:etiology; D006801:Humans; D006959:Hyperoxaluria / Q000209:etiology; D007082:Ileum / Q000601:surgery; D007410:Intestinal Diseases / Q000209:etiology*; D007669:Kidney Calculi / Q000209:etiology; D008875:Middle Aged; D010018:Osteomalacia / Q000209:etiology; D010024:Osteoporosis / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology*; D014547:Urinary Diversion / Q000379:methods*; D014549:Urinary Incontinence / Q000601:surgery*; D014806:Vitamin B 12 Deficiency / Q000209:etiology; D014808:Vitamin D Deficiency / Q000209:etiology
D002118:Calcium
Ileozystoplastik und Enteropathien.