The gastrointestinal composite urinary reservoir in patients with myelomeningocele and exstrophy: Long-term metabolic followup

P. F. Austin, R. C. Rink, J. L. Lockhart

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Purpose: We investigated the long-term metabolic effects of gastrointestinal composite urinary reservoirs in patients with myelomeningocele or exstrophy. Materials and Methods: Seven patients with myelomeningocele or exstrophy who required complex urinary reconstruction in the setting of metabolic acidosis or the short bowel syndrome underwent construction of a gastrointestinal composite reservoir, including a staged and a single procedure in 3 and 4, respectively. Preoperatively and postoperatively serum electrolytes were measured, and urinalysis and urine cultures were performed in all patients. In 5 patients serum pH was compared preoperatively and postoperatively, and in all serum gastrin was measured postoperatively. Results: At an average followup of 62 months (range 52 to 87) serum chloride and bicarbonate significantly normalized (p <0.05) in all 7 patients with bladder exstrophy or myelomeningocele. Serum pH also significantly normalized (p <0.05) in 5 patients at long-term followup. Serum gastrin and creatinine were normal and urinary pH fluctuated insignificantly throughout followup. None of the patients had urolithiasis or symptoms of the hematuria-dysuria syndrome. Periodic symptomatic urinary tract infections developed but none required chronic antibiotic therapy. Conclusions: Gastrointestinal composite urinary reservoirs appear to be beneficial for patients with myelomeningocele or exstrophy who have preexisting metabolic acidosis or the short bowel syndrome. Serum electrolyte neutrality is achieved during long-term followup. No patient had the hematuria-dysuria syndrome or urolithiasis.

Original languageEnglish (US)
Pages (from-to)1126-1128
Number of pages3
JournalJournal of Urology
Volume162
Issue number3 II
DOIs
StatePublished - Jan 1 1999

Keywords

  • Bladder
  • Exstrophy, bladder
  • Meningomyelocele
  • Reservoir, continent urinary

ASJC Scopus subject areas

  • Urology

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