Impaired bone metabolism following augmentation cystoplasties in growing rats.
OBJECTIVE
The aim of this study was to evaluate the possible risk of impaired bone metabolism following augmentation cystoplasties with different gastrointestinal segments.


METHODS
60 young rats underwent augmentation cystoplasties using gastric, ileal or sigma segments, or sham operations. An additional group undergoing sigma-cystoplasty received the bisphosphonate ibandronate to inhibit osteoclast-mediated bone resorption. Bone mass in the lumbar spine and tibia was analyzed monthly by in vivo densitometry. Bone turnover was assessed monthly using current bone metabolism markers for a period of 16 weeks. Bone ashing and serum analyses of the osteotropic hormones parathyroid hormone (PTH), and 25-OH vitamin D3 were performed at study conclusion.


RESULTS
Following ileocystoplasty, reduced bone mineral density (BMD) was seen throughout the observation period; this was pronounced in the trabecular bone. The decline in BMD was associated with decreased serum 25-OH vitamin D3 levels. Following sigmacystoplasty, bone calcium content was significantly decreased; this could be prevented by ibandronate. No skeletal changes occurred in the gastrocystoplasty group. Serum pH was not altered in any group, and markers of bone resorption indicated normal bone resorption rates.


CONCLUSIONS
There is a significant correlation between impaired bone metabolism and the type of segment used for bladder augmentation. While the use of the ileum (and probably the colon too) causes osteopenia, gastrocystoplasties seem to have little influence on bone turnover.
Brkovic
D
D
Department of Urology, Ruprecht Karls University, Heidelberg, Germany. brkovic-drasko@t-online.de
Seibel
M
M
Kissling
C
C
Dörsam
J
J
Wiesel
M
M
Staehler
G
G
Bauss
F
F
D015502:Absorptiometry, Photon; D000818:Animals; D015519:Bone Density; D001842:Bone and Bones / Q000378:metabolism*; D002117:Calcitriol / Q000097:blood; D012809:Colon, Sigmoid / Q000601:surgery; D005260:Female; D007082:Ileum / Q000601:surgery; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D010281:Parathyroid Hormone / Q000097:blood; D051381:Rats; D017207:Rats, Sprague-Dawley; D013270:Stomach / Q000601:surgery; D013977:Tibia / Q000000981:diagnostic imaging; D013997:Time Factors; D016476:Urinary Reservoirs, Continent
D010281:Parathyroid Hormone; D002117:Calcitriol