Factors causing variation in urinary N-nitrosamine levels in enterocystoplasties.
OBJECTIVE
To establish the presence or absence of any diurnal or long-term variation in N-nitrosamine levels (which might be important in the development of cancer in enterocystoplasties) in enterocystoplasty urine, and to assess other factors that might alter enterocystoplasty N-nitrosamine levels. Patients, subjects and methods Thirty-six patients with enterocystoplasties and six normal controls were assessed. Urine samples were collected every 4 h over a 24-h period and N-nitrosamine levels determined using a modification of the Pignatelli


METHODS
An additional urine sample was assessed by microscopy, culture and sensitivity. In a subgroup of 16 patients with an enterocystoplasty, the urinary N-nitrosamine levels were re-measured at 3-monthly intervals.


RESULTS
No diurnal or long-term variation in urinary N-nitrosamine levels was identified. The mean N-nitrosamine levels were significantly higher in the cystoplasty group than in the controls (1.7 vs 1.0 micromol/L; P = 0.008). Mean N-nitrosamine levels were also significantly higher in enterocystoplasty patients with sterile pyuria than in those with no pyuria (P = 0.01). Those taking prophylactic antibiotics had significantly lower mean N-nitrosamine levels than those not doing so (P = 0.05). Individuals with infected urine and those needing to intermittently catheterize had higher N-nitrosamine levels than their counterparts, but this difference was not significant. Conclusion There were no diurnal or long-term variations in urinary N-nitrosamine levels. Levels were consistently higher in patients with inflamed or infected cystoplasties, those using intermittent self-catheterization and those not taking antibiotic prophylaxis.
Woodhams
S D
SD
Institute of Urology & Nephrology, 48 Riding House Street, London W1P 7PN, UK.
Greenwell
T J
TJ
Smalley
T
T
Mundy
A R
AR
D000293:Adolescent; D000328:Adult; D000368:Aged; D002273:Carcinogens / Q000378:metabolism*; D002940:Circadian Rhythm; D015653:Cystectomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009602:Nitrosamines / Q000652:urine*; D012648:Self Care; D001749:Urinary Bladder Neoplasms / Q000209:etiology / Q000517:prevention & control* / Q000652:urine; D014546:Urinary Catheterization; D016476:Urinary Reservoirs, Continent / Q000009:adverse effects
D002273:Carcinogens; D009602:Nitrosamines