0000000000485273
AUTHOR
Karen Davis
Vitamin B12 Deficiency in Children after Continent Urinary Diversion by Mainz Pouch Technique
Purpose MAINZ pouch I urinary diversion provides a high-capacity, low-pressure reservoir. The use of terminal ileum can cause a decrease of vitamin B12 levels. Symptoms caused by vitamin B12 deficiency are rare, but some are irreversible, therefore annual check-ups are recommended. In this study the vitamin B12 levels in the above patients were analyzed in retrospect. Material and Methods The ileocecal segment was used for urinary tract reconstruction in > 80 children ≤17 years of age. B12 levels were determined at various time points within up to 21 years after surgery in 63 patients (8 with ileocecal bladder substitution, 55 continent cutaneous diversion). B12 values below 200pg/ml were c…
Acid-Base Balance after Continent Urinary Diversion in Childhood – Risk of Imbalance Despite Medication
Purpose Continent urinary-intestinal diversion can lead to alterations of the acid-base balance, acutely and chronically, the latter possibly causing bone demineralization. Annual check-ups have therefore been recommended for decades. Material and Methods At our institution, 89 children underwent continent urinary diversion by ileocecal pouch or bladder substitution between 1984 and 2006. In 58 of these patients (age 3-17 y., median 13.9 y.), we performed a minimum of 3 (range 3-23, median 6.2) consecutive annual blood-gas analyses over a follow-up period of up to 23 years (median 11.0) after surgery. At a base excess (BE) (as marker of the acid-base-balance) value below -2.5 mmol/l, treatm…