Urolithiasis in enterocystoplasties
Tóm tắt
The incidence of stones in patients with enterocystoplasty is reported as 12–52.5%. Most patients will have multiple physical factors such as immobility, need for self catheterisation and poor urine drainage, so that it is not certain that an intestinal reservoir is the cause of stones on its own. There is little or no evidence that mucus is an aetiological factor. Foreign bodies in the reservoir, such as staples, increase the risk of stone formation from 13% to 43%. Stones require surgical removal. Minimally invasive techniques may be used for small stones. A low velocity disintegrator is required so that fragments are not propelled into the intestinal mucosa. Stones are infective in origin in 86% of cases, but 14% are sterile. Metabolic screen shows that 80% of patients have risk factors for at least three different types of stone. All patients have raised pH (mean 6.93) and hypocitraturia. Raised serum and urinary calcium, hyperoxaluria and hyperuricosuria are found in up to 33% of patients.
Tài liệu tham khảo
Allison MJ, Dawson KA, Mayberry WR, Foss JG. Allison MJ, Dawson KA, Mayberry WR Foss JG (1985) Oxalobacter formigenes gen. nov., sp. nov.: oxalate-degrading anaerobes that inhabit the gastrointestinal tract. Arch Microbiol 141:1–7
Barrosso U, Jednak R, Fleming P, Barthold JS, Gonzalez R (2000) Bladder calculi in children who perform clean intermittent catheterisation. BJU Int 85:879–884
Blyth B, Ewalt DH, Duckett JW (1992) Lithogenic properties of entero-cystoplasty. J Urol 148:575–577
Brough RJ, O’Flynn KJ, Fishwick J, Gough DCS (1998) Bladder washout and stone formation in paediatric enterocystoplasty. Eur Urol 33:500–502
DeFoor W, Minevich E, Reeves D, Tackett L, Wacksman J, Sheldon C (2003) Gastrocystoplasty: long-term follow-up. J Urol 170:1647–1650
Docimo SG, Orth CR, Schulam PG (1998) Percutaneous cystolithotomy after augmentation cystoplasty: comparison with other procedures. Tech Urol 4:43–45
Edin-Liljegren A, Grenabo L, Hedelin H, Jonsson O, Akerlund S, Pettersson S (1996) Concrement formation and urease induced crystallization in urine from patients with continent ileal reservoirs. Brit J Urol 78:57–63
Ginsberg D, Huffman JL, Lieskovsky G, Boyd SD, Skinner DG (1991) Urinary tract stones: a complication of the Kock pouch urinary diversion. J Urol 145:956–959
Gregory JG, Park KY, Schoenberg HW. Gregory JG, Park KY, Schoenberg HW (1977) Oxalate stone disease after intestinal resection. J Urol 117:631–634
Ioannoni B, Chalmers AH (1994) Increased calcium absorption in nephrolithiasis explained by uptake studies in ileal brush border membrane vesicles. Biochem Med Metabol Biol 51:99–104
Kaefer M, Hendren WH, Bauer SB, Goldenblatt P, Peters CA, Atala A et al. (1998) Reservoir calculi: a comparison of reservoirs constructed from stomach and other enteric segments. J Urol 160:2187–2190
Khoury AE, Salomon M, Doche R, Soboh F, Ackerley C, Jayanthi VR et al. (1997) Stone formation after augmentation cystoplasty: the role of intestinal mucus. J Urol 158:1133–1137
Kronner KM, Casale AJ, Cain MP, Zerin MJ, Keating MA, Rink RC (1998) Bladder calculi in the pediatric augmented bladder. J Urol 160:1096–1098
Leonard MP, Dharamsi N, Williot PE (2000) Outcome of gastrocystoplasty in tertiary pediatric urology practice. J Urol 164:947–950
Madersbacher S, Schmidt J, Eberle JM, Theony HC, Burkhard F, Hochreiter W et al. (2003) Long-term outcome of ileal conduit diversion. J Urol 169:985–990
Mathoera B, Kok DJ, Nijman RJM (2000) Bladder calculi in augmentation cystoplasty in children. Urology 56:482–487
Maynard FM, Diockno AC (1982) Clean intermittent catheterisation for spinal cord injury patients. J Urol 128:477–480
N’Dow JMO (1999) Mucus production and mucin gene expression in normal bladder and in intestinal segments transposed into the urinary tract. MD Thesis, University of Newcastle, Newcastle
N’Dow J, Robson CN, Matthews JNS, Neal DE, Pearson JP (2001) Reducing mucus production after urinary reconstruction: prospective randomised trial. J Urol 165:1433–1440
Nurse DE, McInerney PD, Thomas PJ, Mundy AR (1996) Stones in enterocystoplasties. Brit J Urol 77:684–687
Osther PJ, Poulsen AL, Steven K (2003) Stone risk after bladder substitution with the ileal-urethral Kock reservoir. Scand J Urol Nephrol 34:257–261.
Palmer LS, Franco I, Kogan S, Reda E, Bhagwant G, Levitt S (1993) Urolithiasis in children following augmentation cystoplasty. J Urol 150:726–729
Robertson WG (1999) A comprehensive screening procedure for the assessment of patients with recurrent stones. In: Borghi L, Meschi T, Briganti A, Schianchi T, Novarini A (eds) Kidney Stones. Editorial Bios, Cosenza, 407–410
Robertson WG (2003) A risk factor model of stone-formation. Frontiers Biosci 8:1330–1338
Silver RI, Gros D-AC, Jeffs RD, Gearhart JP (1997) Urolithiasis in the exstrophy-epispadias complex. J Urol 158:1322–1326
Steiner MS, Morton RA (1991) Nutritional and gastrointestinal complications of the use of bowel segments in the lower urinary tract. Urol Clin N Am 18:743–754
Terai A, Ueda T, Kakehi Y, Terachi T, Arai Y, Okada Y et al. (1996) Urinary calculi as a late complication of the Indiana continent urinary diversion: comparison with the Kock pouch procedure. J Urol 155:66–68
Wagstaff KE, Woodhouse CRJ, Rose GA, Duffy PG, Ransley PG (1991) Blood and urine analysis in patients with intestinal bladders. Brit J Urol 68:311–316
Woodhouse CRJ, Lennon GM (1998) Management and aetiology of stones in intestinal urinary reservoirs. Brit J Urol 81 [Suppl]:47