[Metabolic aspects of bowel use in urologic surgery].
Urinary diversion, pouches and orthotopic bladder replacement have been made possible by the use of bowel segments in urologic surgery. The most important complications at short and long-term are metabolic disorders due to the permanent contact of urine with the bowel segment or the exclusion of this segment from bowel continuity. Metabolic acid-base problems occur immediately after the derivation beginning and depend on the renal capacity to compensating. The metabolic disorder due to the exclusion of a bowel segment appears generally years later, after complete depletion of physiologic reserves (vitamin B12). Perfect knowledge of early and late metabolic complications of urinary diversion allows a more accurate indication, a more adequate selection of the derivation type, an improved patient followup, and better long-term results. Metabolic complications constitute the best selection criteria for urinary diversion; subsequently, only a few techniques are likely to persist in the future.
de Petriconi
R
R
Urologische Klinik und Poliklinik der Universität Ulm, Prittwitzstr. 42-43, D 89075 Ulm, Allemagne. robertpetriconi@yahoo.de
D003663:Decision Trees; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism*; D007422:Intestines / Q000637:transplantation*; D014547:Urinary Diversion / Q000009:adverse effects*; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000379:methods