Long-term metabolic effects of urinary diversion: A comparison of myelomeningocele patients managed by clean intermittent catheterization and urinary diversion

Michael Koch, W. S. McDougal, M. C. Hall, D. E. Hill, H. V. Braren, M. N. Donofrio

Research output: Contribution to journalArticle

74 Citations (Scopus)

Abstract

We previously reported that chronic urinary diversion through intestinal segments may have adverse effects on bone and mineral metabolism. This study examined the long-term health of patients managed by urinary diversion (94% by ileal conduit) for neuropathic bladders secondary to myelomeningocele defects and compared them to a control population of myelomeningocele patients managed by intermittent catheterization. Of the patients 93 were studied by personal interview, chart review, morphometric analysis, serum studies and dual-photon bone density determination. Average followup was 23 ± 6 years in the urinary diversion group and 17 ± 5 years in the intermittent catheterization group. Fractures occurred in 40% of the patients in both groups. Patients with a urinary diversion had an increased need for surgery to correct spinal curvature (57% versus 40%) and a significantly increased incidence of complications resulting from orthopedic procedures (17% versus 3%, p ≤0.05). There was also an adverse effect on renal function. The urinary diversion group had an increased incidence of radiographic renal deterioration (57% versus 8%, p

Original languageEnglish (US)
Pages (from-to)1343-1347
Number of pages5
JournalJournal of Urology
Volume147
Issue number5
StatePublished - 1992
Externally publishedYes

Fingerprint

Intermittent Urethral Catheterization
Meningomyelocele
Urinary Diversion
Catheterization
Spinal Curvatures
Orthopedic Procedures
Kidney
Neurogenic Urinary Bladder
Incidence
Photons
Bone Density
Minerals
Interviews
Bone and Bones
Health
Serum
Population

Keywords

  • bone density
  • catheterization
  • mineral
  • urinary diversion

ASJC Scopus subject areas

  • Urology

Cite this

Long-term metabolic effects of urinary diversion : A comparison of myelomeningocele patients managed by clean intermittent catheterization and urinary diversion. / Koch, Michael; McDougal, W. S.; Hall, M. C.; Hill, D. E.; Braren, H. V.; Donofrio, M. N.

In: Journal of Urology, Vol. 147, No. 5, 1992, p. 1343-1347.

Research output: Contribution to journalArticle

Koch, Michael ; McDougal, W. S. ; Hall, M. C. ; Hill, D. E. ; Braren, H. V. ; Donofrio, M. N. / Long-term metabolic effects of urinary diversion : A comparison of myelomeningocele patients managed by clean intermittent catheterization and urinary diversion. In: Journal of Urology. 1992 ; Vol. 147, No. 5. pp. 1343-1347.
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