Postoperative resorptive and excretory capacity of the ileal neobladder.
OBJECTIVE
To assess the extent and mechanism of renal reabsorption and excretion in patients with an ileal neobladder, as mild metabolic acidosis cause by proton reabsorption is common after such surgery, and long-term pharmacological correction is often necessary.


METHODS
The study comprised 30 patients (29 men and one woman) with ileal neobladders after oncological surgery; before surgery all had normal retention values. Before and after withdrawing the transurethral catheter, serum creatinine and urea were analysed and used to assess the effect of the neobladder on retention values, expressed as the percentage change from baseline (Delta creatinine and urea).


RESULTS
There was a significant correlation between the Delta-creatinine and Delta-urea values (P < 0.001; r = 0.66); 15 patients (50%) showed resorption of creatinine and urea, eight (27%) excreted creatinine into the neobladder and resorbed urea from it at the same time, and three (10%) showed the reverse response, i.e. creatinine resorption and urea excretion. Interestingly, four patients (13%) excreted both creatinine and urea into the neobladder.


CONCLUSIONS
We assume that there was both a resorptive and excretory function. Probably the metabolic state (resorption or secretion) of the neobladder depends on its mucus production and on the internal surface, or on diuresis. Further investigation is required to characterize these different influences.
Rinnab
Ludwig
L
Department of Urology and Paediatric Urology, University of Ulm, Germany. ludwig.rinnab@medizin.uni-ulm.de
Straub
Michael
M
Hautmann
Richard E
RE
Braendle
Edgar
E
D000368:Aged; D003404:Creatinine / Q000378:metabolism; D005260:Female; D006801:Humans; D007082:Ileum / Q000378:metabolism / Q000637:transplantation; D007408:Intestinal Absorption / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D014508:Urea / Q000378:metabolism; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods*; D016476:Urinary Reservoirs, Continent / Q000502:physiology*
D014508:Urea; D003404:Creatinine