Some biochemical changes in urinary bladder cancer patients after orthotopic ileocecal bladder substitution

Abstract

For more than a century, intestinal segments have been used in reconstruction of the urinary tract after radical cystectomy. The well­ known potential complication of the different types of urinary diversion is hyperchloremic metabolic acidosis, which is due mainly to reabsorption of hydrogen ions together with chloride ions from urine in contact with interposed segments. The evolution of continent reservoirs and bladder substitutes in the last decade had intailed interposition of intestinal segments of considerable length in the urinary tract. Several techniques had been used in the reconstruction of the lower urinary tract using different intestinal segments. Since performed the first ureterosigmoidostomy, a multitude of procedures with countless modifications h!ld been reported involving all types of intestinal segments. The positioning of the intestine in contact with the urinary stream had not been without significant metabolic complications. It is known that the function of intestinal segments is to absorb solutes and water, so, the metabolic consequences of urinary diversion are the direct result of the physiological interaction of the intestinal mucosa with urinary solutes. The rate and mechanism of absorption of dietary water, electrolytes, and nutrients vary from colon to ileum to jejunum. In certain parts of the bowel, under various conditions, a net loss of water and electrolytes can occur.