The advent of modem reconstructive techniques in urologic surgery has allowed a wide use of intestinal segments in young and older patients. Intestinal conduits and reservoirs can produce a series of complications due to hydroelectrolytic disturbances, alterations of acid-base balance and of bone and hepatic metabolism, intestinal malabsorption. The severity of clinical features depends on the quantity of solute exchanges through the mucosa of the intestinal segment used and on the “age” of the conduit or reservoir.
BoydS.D., SchiffW.M., SkinnerD.G., LieskovskyG., KanellosA.W., KlimaszewskiA.D.: Prospective study of metabolic abnormalities in patients with continent Kock pouch urinary diversions. Urology, 33: 85, 1989.
3.
ThuroffJ.W., AikenP., HohenfellnerR.: The Mainz pouch for bladder augmentation and continent diversion. In: Bladder reconstruction and continent urinary diversion. Edited by KingL.R., StoneA.R., WebsterG.D. Chicago, Year Book Medical Publisher, 252–268, 1987.
4.
JohnsonL.R., ChristensenJ., JacksonM.J., JacobsonE.D., WalshJ.H.: Physiology of the gastrointestinal tract. New York, Raven Press, 1987.
5.
SchubertM.L., ShamburekR. D.: Control of acid secretion. Gastroenter. Clin. N. Amer., 19: 1, 1990.
6.
LimS.T.K., LamS.K., LeeN.W., WongJ., OngG.B.: Effects of gastrocystoplasty on serum gastrin levels and gastric acid secretion. Brit. J., Surg., 70: 275, 1983.
7.
GolimbuM., MoralesP.: Jejunal conduits: technique and complications. J. Urol., 113: 787, 1975.
8.
KockM.O., McDougalW.S., ThompsonC. O.: Mechanisms of solute transport following urinary diversion through intestinal segments: an experimental study with rats. J. Urol., 146: 1390, 1991.
9.
CastroJ.E., RamM. D.: Electrolyte imbalance following ileal urinary diversion. Brit. J. Urol., 42: 29, 1970.
10.
SchmidtJ.D., HawtreyC.E., FlocksR.H., CulpD. A.: Complications, results and problems of ileal conduit diversions. J. Urol., 109: 210, 1973.
11.
McDougalW.S., KockM. O.: Impaired growth development and urinary intestinal interposition. Trans. Amer. Ass. Genito-Urin. Surg., 105: 3, 1991.
12.
KockM.O., McDougalW. S.: Chlorpromazine: adjuvant therapy for the metabolic derangements created by urinary diversions through intestinal segments. J. Urol., 134: 165. 1985.
13.
KockM.O., McDougalW. S.: Nicotinic acid: treatment for the hyperchloremic acidosis following urinary diversions through intestinal segments. J. Urol., 134: 162, 1985.
14.
AldreyA.C.: Disorders of magnesium metabolism. In: The kidney: physiology and pathophysiology. Edited by SeldinD.W., GiebishG., New York, Raven Press, 2 (54): 1281–1296, 1985.
15.
KochM.O., McDougalW. S.: The pathophysiology of hyperchloremic metabolic acidosis after urinary diversion through intestinal segments. Surgery, 98: 561, 1985.
McDermottW.V.Jr.: Diversion of urine to the intestines as a factor in ammoniagenic coma. New Engl. J. Med., 256: 460, 1957.
18.
JonesW.G.II, BarberA.E., MinieJ.P., FabeyT.J.III, ShiresG.T.III, ShiresG.T.: Differential pathophysiology of bacterial translocation after thermal injury and sepsis. Ann. Surg., 214: 24, 1991.
19.
McDougalW.S., WilmoreD.W., PruittB.A.Jr.: Glucose-dependent hepatic membrane transport in non-bacteremic and bacteremic thermally injured patients. J. Surg. Res., 22: 697, 1977.
20.
EdwardsR.H.: Hyperammonemie encephalopathy related to ureterosigmoidostmy. Arch. Neurol., 41: 1211, 1984.
21.
SilbermanR.: Ammonia intoxication following ure-terosigmoidostomy in a patient with liver disease. Lancet, 2: 937, 1958.
22.
McDougalW.S., KockM. O.: Effect of sulfate on calcium and magnesium homeostasis following urinary diversion. Kidney Int., 35: 105, 1989.
23.
GreenJ., KleemanC.R.: The role of bone in the regulation of systemic acid-base balance. In: Morii H. (ed.), Calcium transport, bone metabolism and new drugs, Karger Basel., 91: 61–76, 1991.
24.
PoyartC.F., BursauxE., FrèminetA.: The bone C02 compartment: evidence for a bicarbonate pool. Resp. Physiol., 25: 89–99, 1975.
25.
KrautJ.A., GordonE.M., RansomJ.C., CoburnJ.W., KurokawaK.: The effect of chronic metabolic acidosis on the end organ responsiveness to parathyroid hormone in man. J. Clin. Endocrinol. Metab., 56: 619–622, 1983.
26.
HarrisonA.R.: Clinical and metabolic observations on osteomalacia following ureterosigmoidostomy. Brit. J. Urol., 30: 455, 1958.
27.
SiklosS., DavieM., JumgR.T., ChalmersT. M.: Osteomalacia in ureterosigmoidostomy: healing by correction of the acidosis. Brit. J. Urol., 52: 61, 1980.
28.
PertyW., AllenL.N., StampT.C.B., WalkerP.G.: Vitamin D resistance in osteomalacia after ureterosigmoidostmy. New Engl. J. Med., 297: 1110, 1977.
29.
LeeS.W., RusselJ., AvioliL. V.: 25-Hydroxycholecalci-ferol to 1,25-dihydroxycholecalciferol: conversion impaired by systemic metabolic acidosis. Science, 195: 994, 1977.
