Metabolic findings after colocystoplasty in children

Vajda, Péter; Pintér, Andrew; Harangi, Ferenc; Farkas, A.; Vastyan, Attila M.; Oberritter, Zsolt

doi:10.1016/s0090-4295(03)00580-6

Cited by 26 publications

(10 citation statements)

References 18 publications

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“…These vary depending on the type of gastro-intestinal segment used [1][2][3]. Due to the risks of metabolic disturbances and other potential complications, patients need long and continuous followup and care [4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Quality of life: urinary bladder augmentation or substitution in children

et al. 2009

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Section: Introductionmentioning

confidence: 99%

Quality of life: urinary bladder augmentation or substitution in children

et al. 2009

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“…Although it is rarely encountered and controversial data have been reported, studies did demonstrate that the procedure could have some effects on bone mineral metabolism in adults [7,8]. However, in children who had urinary diversions, decrease in linear growth and alterations in bone mineral content were reported repeatedly [9][10][11][12][13][14]. These children with decreased linear growth and bone mineral density (BMD) often have neurologic deficits that may affect growth and therefore making it difficult to assess the effect of performed surgical procedure on growth [15].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of bone mineral density after ileocystoplasty in children with and without myelomeningocele

et al. 2006

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We evaluated the bone mineral density (BMD) after ileal augmentation cystoplasty in a group of children with and without myelomeningocele. Between 1996 and 2003, eight patients with neurogenic bladder and seven patients with non-neurogenic bladder underwent augmentation ileocystoplasty. Preoperative and postoperative serum creatinine and electrolytes were measured. All patients underwent clinical evaluation, supine height measurement, blood gas analysis, and BMD measurement using a dual energy X-ray absorptiometry (DEXA) postoperatively. BMD was measured at L1-L4 and femoral neck, and compared to age- and sex-matched population. Follow-up time was calculated from the day of surgery to the day of DEXA performance. A total of eight boys and seven girls with the mean age of 10.2 +/- 4.1 years were evaluated with respect to BMD measurement. Mean age was 9.8 years in neurogenic group and 10.5 in non-neurogenic group. Mean follow-up was 728 and 616 days in neurogenic and non-neurogenic groups, respectively. There were no significant differences between ages, follow-up times, preoperative and postoperative creatinine levels, pH and bicarbonate values, and supine heights. Mean BMD at L1-L4 was 55.7% in neurogenic group and 83.8% in non-neurogenic group. There was a statistically significant difference between the two groups (P = 0.02). Mean BMD at femoral neck was 72% in neurogenic group and 86.2% in non-neurogenic group. The difference was also statistically significant (P = 0.028). After augmentation ileocystoplasty, the BMD in early postoperative period of patients with myelomeningocele is lower than the patients with non-neurogenic neurogenic bladder, which have the same clinical characteristics except the neurologic pathology. In the light of our findings and the reported literature data as well, we may claim that BMD decrease after augmentation ileocystoplasty depends more on the underlying neurologic pathology and its locomotor consequences rather than the enterocystoplasty itself.

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“…[10] Similarly, in another study of 28 children who underwent enterocystoplasty, no change in growth was reported in children augmented with colon. [11] In children augmented with sigmoid, the average linear growth had decreased during the first year postoperatively, but had recovered to preoperative percentiles two years after surgery. [11] Mingin et al .…”

Section: Discussionmentioning

confidence: 99%

“…[11] In children augmented with sigmoid, the average linear growth had decreased during the first year postoperatively, but had recovered to preoperative percentiles two years after surgery. [11] Mingin et al . [4] had reported no change in linear growth among 22 augmented meningomyelocele patients and 11 augmented exstrophy children when compared to their controls.…”

Section: Discussionmentioning

confidence: 99%

Exstrophy bladder: Effect of sigmoid colocystoplasty on physical growth and bone mineral density

Tandon

Bhatnagar

2011

J Indian Assoc Pediatr Surg

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Background and Aims:Introduction of intestinal tissue in the urinary tract results in numerous metabolic changes. This study investigates the effects of augmentation sigmoid colocystoplasty on the physical growth and bone mineralization in bladder exstrophy patients.Materials and Methods:Physical growth, serum biochemistry and bone mineral density were assessed pre and post augmentation in 34 of 54 patients who were treated by staged sigmoid colocystoplasty for classical bladder exstrophy during the period 1985–2007. Physical growth was determined by comparing the height and weight for age with standard growth charts. Serum biochemistry included calcium, phosphate and alkaline phosphatase levels. Bone mineral density (BMD) was determined at the femoral head using the dual energy X-ray absorptiometry (DEXA) scan at 15 ± 4.5 months after the augmentation. The DEXA scan findings were compared with 22 normal Indian children who served as controls and 18 unaugmented patients with bladder exstrophy. In 13 augmented patients, the DEXA scan could be repeated after an interval of six months.Results:The mean percentile height and weight were comparable in the pre and post-augmentation period with no statistically significant difference (P=0.135 for height and P=0.232 for weight). Biochemical parameters of bone metabolism also did not show any statistically significant changes after colocystoplasty. The BMD was 0.665 ± 0.062 g/cm2 in the controls and 0.612 ± 0.10 g/cm2 in the unaugmented bladder exstrophy patients. In the augmented patients, the BMD was 0.645 ± 0.175 g/cm2 and six months later it was 0.657 ± 0.158 g/cm2. These differences were not statistically significant.Conclusions:In our study, no significant effects on the physical growth and bone mineral metabolism were observed in exstrophy bladder patients following sigmoid colocystoplasty.

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Metabolic findings after colocystoplasty in children

Cited by 26 publications

References 18 publications

Quality of life: urinary bladder augmentation or substitution in children

Quality of life: urinary bladder augmentation or substitution in children

Evaluation of bone mineral density after ileocystoplasty in children with and without myelomeningocele

Exstrophy bladder: Effect of sigmoid colocystoplasty on physical growth and bone mineral density

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