Major Changes in Urine Investigations after Orthotopic Cystectomy with Ileal Neobladder

摘要

Background: urinary and metabolic changes differ in their severity and consequences. The severity of these changes is directly related to the type of bowel segment, surface area of bowel used, duration of urine storage concentration of solutes in urine, urinary PH and osmolarity, medications and underlying renal and hepatic function of the host. Aim of the work: this study aimed to characterize the physical, chemical and biological characters of urine in patients who underwent radical cystectomy with ileal neobladder and these could be utilized as a nomogram to which urine disorders in diversion patients were compared. Design : this was a retrospective cohort. Patients and Methods : this study was a prospective cohort and it included 150 patients and it was carried out in outpatient Clinic of Urology and Oncology Centers. 100 patients had radical cystectomy and ileal neobladder at least 6 months before the study. 50 of them were on alkaline treatment, the rest 50 were not. The last 50 were served as the control group. Also, all the patients had signed consent for taking their information in this study. Results: this study included 150 patients who underwent radical cystectomy and ileal neobladder. The mean age + Sd was 59.8 + 9.5 and for the control group was 47.6 + 8.7 with no significant difference (p value 0.08). No significant difference was detected between both diversion groups as regard demographics (including sex) and follow up period except taking oral urine alkalinizers. Conclusion : the urine excreted from diverted patients differed from those with normal bladder and this would be of real importance to announce and increase the awareness among the treating physicians including the general practitioners, the urologists and other health providers. They have to know that those patients do not have a classic urinary bladder that is to say their urine is not real urine representing the urinary tract and this may avoid a lot of unnecessary procedures or to protect such group of patients from unrecognized clinical and medical mistakes.