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Renal function in the setting of urinary diversion

Kristjansson, A and Månsson, Wiking LU (2004) In World Journal of Urology 22(3). p.172-177
Abstract
Incorporating bowel into the urinary tract sets the stage for a potentially dangerous situation for the upper part of this tract. Obstruction, reflux and chronic bacteriuria may develop, all of which can all be detrimental. Most reports on renal function have used IVP and serum creatinine only, methods which are inadequate for proper assessment. Long-term follow-up of patients with ileal conduit diversion reveals a high incidence of morphological and/or functional damage to the kidneys. Refluxing techniques for implanting the ureters have usually been employed. In patients with continent cutaneous diversion or orthotopic bladder substitution, some recent publications have shown rather well preserved glomerular filtration rates.... (More)
Incorporating bowel into the urinary tract sets the stage for a potentially dangerous situation for the upper part of this tract. Obstruction, reflux and chronic bacteriuria may develop, all of which can all be detrimental. Most reports on renal function have used IVP and serum creatinine only, methods which are inadequate for proper assessment. Long-term follow-up of patients with ileal conduit diversion reveals a high incidence of morphological and/or functional damage to the kidneys. Refluxing techniques for implanting the ureters have usually been employed. In patients with continent cutaneous diversion or orthotopic bladder substitution, some recent publications have shown rather well preserved glomerular filtration rates. Traditionally, antirefluxing ureteric implantation has been used in these patients. There is presently a trend towards refluxing anastomosis in this setting, providing a low pressure pouch has been constructed. However, pressure can be high in such pouches and bacteriuria is common. The consequences for the fate of the upper urinary tract is unknown and caution should be exercised in recommending such techniques. There is clearly a need for prospective randomized controlled studies on the issue of refluxing versus antirefluxing anastomosis in continent urinary reconstruction. Patients with continent or non-continent diversion should have lifelong follow-up with regard to the upper urinary tract. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
neobladder, urinary diversion, kidney, renal function, conduit
in
World Journal of Urology
volume
22
issue
3
pages
172 - 177
publisher
Springer
external identifiers
  • wos:000224915600004
  • pmid:15340756
  • scopus:16644379030
ISSN
1433-8726
DOI
10.1007/s00345-004-0431-y
language
English
LU publication?
yes
id
9c1a3d24-b544-4ae0-ba43-4406f8367e29 (old id 262245)
date added to LUP
2007-10-23 19:41:59
date last changed
2017-08-06 04:36:45
@article{9c1a3d24-b544-4ae0-ba43-4406f8367e29,
  abstract     = {Incorporating bowel into the urinary tract sets the stage for a potentially dangerous situation for the upper part of this tract. Obstruction, reflux and chronic bacteriuria may develop, all of which can all be detrimental. Most reports on renal function have used IVP and serum creatinine only, methods which are inadequate for proper assessment. Long-term follow-up of patients with ileal conduit diversion reveals a high incidence of morphological and/or functional damage to the kidneys. Refluxing techniques for implanting the ureters have usually been employed. In patients with continent cutaneous diversion or orthotopic bladder substitution, some recent publications have shown rather well preserved glomerular filtration rates. Traditionally, antirefluxing ureteric implantation has been used in these patients. There is presently a trend towards refluxing anastomosis in this setting, providing a low pressure pouch has been constructed. However, pressure can be high in such pouches and bacteriuria is common. The consequences for the fate of the upper urinary tract is unknown and caution should be exercised in recommending such techniques. There is clearly a need for prospective randomized controlled studies on the issue of refluxing versus antirefluxing anastomosis in continent urinary reconstruction. Patients with continent or non-continent diversion should have lifelong follow-up with regard to the upper urinary tract.},
  author       = {Kristjansson, A and Månsson, Wiking},
  issn         = {1433-8726},
  keyword      = {neobladder,urinary diversion,kidney,renal function,conduit},
  language     = {eng},
  number       = {3},
  pages        = {172--177},
  publisher    = {Springer},
  series       = {World Journal of Urology},
  title        = {Renal function in the setting of urinary diversion},
  url          = {http://dx.doi.org/10.1007/s00345-004-0431-y},
  volume       = {22},
  year         = {2004},
}