Increased urinary 8‐hydroxy‐2′‐deoxyguanosine excretion after ileal neobladder replacement

Abstract

types of orthotopic neobladder, the ileal conduit and in the healthy controls were compared. RESULTSThe mean ( SD ) ratios of urinary 8-OHdG to urinary creatinine in patients with an ileal neobladder, colon neobladder, ileal conduit and in controls were 20.4 (7.8), 15.2 (4.3), 15.9 (5.1) and 15.2 (5.4) ng/mg, respectively. The urinary 8-OHdG ratio in the first group was significantly higher than in the other three groups. Among patients with a neobladder, the urinary 8-OHdG ratio was closely associated with the degree of pyuria, but not age, gender, the interval from surgery, body weight, height, serum creatinine or the degree of metabolic acidosis. CONCLUSIONSThese findings suggest that creating an ileal neobladder caused significantly greater oxidative stress than a colon neobladder, ileal conduit, or that in healthy controls. Therefore, it is recommended to conduct a careful longterm follow-up considering the possible development of malignant disease after urinary diversion, especially by an ileal neobladder. KEYWORDS 8-OHdG, ileal neobladder, colon neobladder, ileal conduit OBJECTIVESTo examine whether orthotopic neobladder replacement using either ileum or colon segments results in increased oxidative stress, by measuring urinary 8-hydroxy-2 ¢ -deoxyguanosine (8-OHdG), one of the most commonly used markers for evaluating oxidative DNA damage. PATIENTS, SUBJECTS AND METHODSUrinary levels of 8-OHdG and creatinine, urine analysis, nutritional status, and acid-base and electrolyte balances, were assessed in 22 patients with an ileal neobladder, 28 with a colon neobladder, 37 with an ileal conduit and 22 healthy volunteers. The results from both

Long‐term functional outcomes in patients with various types of orthotopic intestinal neobladder

“…Functional outcomes, such as voiding pattern and continent status, following the reconstruction of intestinal orthotopic NB have been extensively investigated in the literature; however, there have been few reports comparing long‐term functional outcomes among patients receiving different types of orthotopic NB creation 3–5 . At our institutions, since 1983, orthotopic NB replacement after radical cystectomy has been carried out in more than 400 patients with invasive bladder cancer, and the preferred types of NB have changed during this period 9–18 . In this study, therefore, we retrospectively analyzed the data associated with functional outcomes of 89 patients who underwent orthotopic NB reconstruction after radical cystectomy and were followed for at least 5 years in order to characterize differences in functional outcomes among several types of NB created at our institutions.…”

Experience with Various Types of Orthotopic Neobladder in Japanese Men: Long-Term Follow-Up

“…Since 1983, orthotopic NB reconstruction has been performed in more than 400 patients who were treated with radical cystectomy for invasive bladder cancer at our institutions, suggesting that the outcomes obtained from our data may reliable and comparable with other studies performed in high-volume centers. However, the preferred types of NB at our institutions have changed during this period [13,[19][20][21] , therefore the number of patients became very different according to the type of NB created. Despite the inadequacy of this imbalance, it would also be important to include data from consecutive patients fulfilling the criterion of this study.…”

Elevated urinary cytokine levels in patients undergoing ileal neobladder replacement compared with sigmoid neobladder replacement

“…Orthotopic neobladder replacement using intestinal segments has recently become the most preferred method of urinary diversion in appropriately selected patients [1][2][3][4][5]. At our institutions, neobladder creation following radical cystectomy using ileum or sigmoid colon has been mainly performed [14][15][16], and based on this experience, we have investigated differences in several characteristics between these two types of neobladder [17][18][19][20]. In this study, we retrospectively analyzed the clinical features associated with urinary tract infection and measured the urinary levels of three major cytokines, IL-1b, IL-6, and IL-8, in 20 patients with ileal neobladder and 22 with sigmoid neobladder in order to characterize the significance of inflammatory conditions after orthotopic neobladder replacement.…”

“…The reconstruction of neobladder was performed using the ileum for 20 patients [14] or the sigmoid colon [15,16] for 22 patients. The indication for orthotopic neobladder replacement and the postoperative follow-up schedule at our institutions were previously reported [17]. Except during the perioperative period, none of the patient received antibiotic therapy for active urinary tract infection.…”