D-xylose absorption after urinary orthotopic bladder replacement: colon neobladder compared with ileal neobladder.
BACKGROUND
To evaluate the digestive and absorptive status using the D-xylose test in patients who underwent radical cystectomy and orthotopic bladder replacement either by colon or ileal segment.


METHODS
D-xylose serum levels after an oral load, nutritional status, plasma vitamin B12 levels, and acid-base and electrolyte balances were studied in 18 patients with colon neobladder and 12 patients with ileal neobladder. Mean follow-up period was 51 months. Results of both types of bladder replacement and a healthy control group were compared.


RESULTS
Although no significant difference in the changes of plasma levels of D-xylose after oral load was observed between patients with colon neobladder and healthy controls, plasma levels of D-xylose 90 min after oral load in patients with ileal neobladder were significantly lower than those with colon neobladder. In contrast, there was no significant difference in nutritional status, plasma levels of vitamin B12, and acid-base and electrolyte balances between patients with colon and ileal neobladders.


CONCLUSIONS
Despite acceptable nutritional status, intestinal malabsorption might be present in patients with ileal neobladder, as indicated by the plasma levels of D-xylose, while the colon neobladder group showed no significant differences compared with normal controls. Therefore, absorptive and metabolic status should be carefully monitored after ileal neobladder creation.
Hara
Shoji
S
Department of Urology, Kobe University School of Medicine, Kobe, Japan. hara@med.kobe-u.ac.jp
Miyake
Hideaki
H
Okada
Hiroshi
H
Arakawa
Soichi
S
Kamidono
Sadao
S
Hara
Isao
I
D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D003106:Colon / Q000601:surgery*; D015653:Cystectomy / Q000009:adverse effects*; D005260:Female; D005492:Folic Acid / Q000097:blood; D005500:Follow-Up Studies; D006397:Hematinics / Q000097:blood; D006801:Humans; D007082:Ileum / Q000601:surgery*; D008286:Malabsorption Syndromes / Q000097:blood / Q000175:diagnosis* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D014547:Urinary Diversion / Q000009:adverse effects*; D016476:Urinary Reservoirs, Continent / Q000009:adverse effects*; D014994:Xylose / Q000008:administration & dosage
D006397:Hematinics; D005492:Folic Acid; D014994:Xylose