Abstract
Recent reports have shown that metabolic acidosis is a possible complication in patients who undergo augmentation enterocystoplasty. We studied 30 patients with neurogenic bladder who underwent sigmoidocystoplasty. Follow-up ranged from 1 to 10 years; all the patients showed normal renal function. We found significant hyperchloremic acidosis in 10% and borderline acidosis in 27% of the patients. Abnormalities of calcium and phosphorus balance were noted in 16.5% and 43% of the patients respectively, and more frequently in acidolic patients, which might be the result of activation of the bony buffers and might cause delayed growth in children. Close follow-up of all patients with enterocystoplasty is required, and oral bicarbonate is indicated when acidosis is detected.
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Beseghi U, Casolari E, Del Rossi C, Ghinelli C (1994) Enterocystoplasty with a sigmoid patch in children with neurogenic bladder dysfunction. Pediatr Surg Int 9: 82–85
Bettice JA (1984) Skeletal carbon dioxide during metabolic acidosis. Am J Physiol 247: 326–330
Birge SJ, Avioli LV (1992) Pathophysiology of calcium and phosphate absorptive disorders. In: Avioli LV, Krane J. eds Metabolic bone disease and clinically related disorders, 2nd edn. WB Saunders, Philadelphia p 231
Blyth B, Ewalt DH, Duckett JW, Snyder HM (1992) Lithogenic properties of enterocystoplasty. J Urol 148: 575–577
Bravermann RM, Lebowitz RL (1991) Perforation of augmented urinary bladder in nine children and adolescents: importance of cystography. Am J Radiol 157: 1059–1063
Bricker EM (1950) Bladder substitution after pelvic evisceration. Surg Clin North Am 30: 1511–1521
Bushinsky DA (1988) Net proton influx into bone during metabolic, but not respiratory acidosis. Am J Physiol 254: 306–310
Bushinsky DA (1994) Acidosis and bone. Miner Electrol Metab 20: 40–52
Caprilli A, Frieri G, Latella G, Gallucci M, Bracci U (1986) Electrolyte and acid base imbalance in patients with rectosigmoid bladder. J Urol 135: 148–150
Davis GR, Morawski G, Santana C (1983) Evaluation of chloride/bicarbonate exchange in the human colon in vivo. J Clin Invest 71: 201–207
Dayanc M, Hurley P, Reinberg Y, Reid C, Gonzales R (1993) Influence of bladder augmentation on growth of children with normal renal function. 2nd ICCS (International Children's Continence Symposium), Proceedings, pp 46–47
Guntapalli J, Eby B, Kai L (1982) Mechanism for the phosphaturia of NH4Cl: dependence on acidemia but not on diet PO4 or PTH. Am J Physiol 242: 553–560
Hendren WH, Hendren RB (1990) Bladder augmentation: experience with 129 children and young adults. J Urol 144: 445–453
Husmann DA, Spence HM (1991) Ureterosigmoidostomy, current concepts. In: King LR, Stone AR, Webster GD (eds) Bladder reconstruction and continent urinary diversion, 2nd edn. Mosby Year Book, St Louis pp 214–215
Kruse K, Kracht U, Gopfert G (1982) Renal threshold of phosphate concentration. Arch Dis Child 57: 217–223
Langberg H, Hartmann A, Kill F (1984) Glomerular filtration rate and plasma pH as determinants of phosphate reabsorption. Kidney Int 26: 128–136
Lemann J, Lennon EJ (1972) Role of diet, gastrointestinal tract and bone in acid-base homeostasis. Kidney Int 1: 275–279
Lemann J, Adams ND, Gray RW (1979) Urinary calcium excretion in human beings. N Engl J Med 301: 535
Marcheggiano A, Iannoni C, Latella G, Frieri G, Diosi D, DeDominicis C, Laurenti C, Caprilli R (1991) Abnormalities of colonic mucin secretion and metabolic changes after internal urinary diversion for bladder exstrophy, a prospective study. Br J Urol 67: 477–482
McConnel JB, Murison J, Stewart WK (1979) The role of colon in the pathogenesis of hyperchloraemic acidosis in ureterosigmoid anastomosis. Clin Sci 57: 305–312
Mitchell ME, Piser JA (1987) Intestinocystoplasty and total bladder replacement in children and young adults: follow-up in 129 cases. J Urol 138: 579–584
Mundy AR, Nurse DE (1992) Calcium balance, growth and skeletal mineralisation in patients with cystoplasties. Br J Urol 69: 257–259
Nurse DE, Mundy AR (1989) Metabolic complications of cystoplasty. Br J Urol 63: 165–170
Olivio G, Biasioli S, Bonciarelli M, Noto S (1993) Metabolic complications of the urinary intestinal diversion: ileo-cecal bladder compared with ileal conduit. Br J Urol 71: 172–175
Portale AA (1994) Calcium and phosphorus. In: Holliday MA, Barratt TM, Avner ED (eds) Pediatric nephrology, William & Wilkins, p 247
Rose BD (1991) Fisiologia clinica dell'equilibrio acido-base e dei disordini elettrolitici, 3rd edn. McGraw Hill pp 232–253
Scharer K, Gilli G (1992) Growth retardation in kidney disease. In: Edelmann CM (ed). Pediatric kidney disease. 593, Little Brown
Spitzer A, Chesney RN (1992) Role of the kidney in mineral metabolism. In: Edelmann CM (ed) Pediatric kidney disease. 147, Little Brown
Wagstaff KE, Woodhouse CRJ, Rose GA, Duffy PG, Ransley PG (1991) Blood and urine analysis in patients with intestinal bladders. Br J Urol 68: 311–316
Wagstaff KE, Woodhouse CRJ, Duffy PG (1992) Delayed linear growth in children with enterocystoplasties. Br J Urol 69: 314–317
Walton RJ, Bijvoet OLM (1975) Normogram for derivation of renal threshold of phosphate concentration. Lancet II: 309–310
Woodhouse CRJ (1992) Lower urinary tract reconstruction in young patients. Br J Urol 70: 113–120
Woodhouse CRJ, Wagstaff KE, Hotam K, Duffy PG, Ransley PG (1991) Metabolic consequences of enterocystoplasty. European Society of Pediatric Urology. Oral presentation. Beaune, April 1991
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Beseghi, U., Guys, J.M., DiBenedetto, V. et al. Metabolic consequences of sigmoidocystoplasty in children. Pediatr Surg Int 11, 150–152 (1996). https://doi.org/10.1007/BF00183750
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DOI: https://doi.org/10.1007/BF00183750