Document Detail


Evaluation of mechanical bowel preparation methods in urinary diversion surgery.
MedLine Citation:
PMID:  17076946     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We performed the first prospective, randomized, multi-center comparison of overall quality and patient tolerability of polyethylene glycol (PEG) and sodium phosphate (NaP) solution for mechanical bowel preparation prior to urinary diversion surgery. METHODS: Between 2001 and 2003, 36 patients at six institutions underwent major urological reconstructive surgery incorporating small intestine (35 radical cystectomy with urinary diversion and 1 bladder augmentation). Patients were prospectively randomized to receive either oral polyethylene glycol (group 1, n = 16) or sodium phosphate (group 2, n = 20) for mechanical bowel preparation prior to surgery, according to our multi-institutional IRB-approved protocol. All patients completed a questionnaire the morning of surgery to assess the tolerability and side effects of each agent. Quality of the bowel preparation was recorded based on intraoperative findings of the attending surgeon, who was blinded to the preparation method. RESULTS: Both bowel cleansing regimens were safe and well tolerated. Patient-reported ease of use and subjective incidence of side effects were statistically similar in the two groups, and a statistically non-significant trend to more bloating in the PEG group was also noted (p = 0.085). Surgeon-scored overall quality of preparation adequacy revealed no significant differences between oral sodium phosphate and polyethylene glycol solutions (p = 0.555). Postoperative complications were rare for each bowel preparation agent. CONCLUSIONS: Performance characteristics of oral sodium phosphate and polyethylene glycol bowel preparations appear to be similar. Each method is safe, efficacious, and well-tolerated when used prior to urinary diversion surgery. The cost for the NaP preparation was $1.40 versus $19.70 for the PEG bowel preparation. Sodium phosphate may have a slight advantage because of its convenience and economic advantage.
Authors:
Allen F Morey; L Andrew Evans; R Clayton McDonough; Alyssa M Park; Wade J Sexton; Joseph W Basler; Richard A Santucci; Christopher L Amling; Keith J O'Reilly
Related Documents :
1914716 - Colectomy for constipation: physiologic investigation is the key to success.
16920416 - Ultrasound-guided hydrostatic reduction of intussusceptions by saline enema: a review o...
20006026 - A comparison of the effectiveness of the soave and martin procedures for the treatment ...
10524876 - Early nasogastric tube removal combined with metoclopramide after radical cystectomy an...
23117166 - Posterior cruciate-retaining versus posterior stabilized total knee arthroplasty: a met...
20727316 - Distal chevron osteotomy with distal soft tissue procedure for moderate to severe hallu...
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Canadian journal of urology     Volume:  13     ISSN:  1195-9479     ISO Abbreviation:  Can J Urol     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-11-01     Completed Date:  2007-02-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9515842     Medline TA:  Can J Urol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  3250-4     Citation Subset:  IM    
Affiliation:
Department of Surgery, Urology Service, Brooke Army Medical Center, Fort Sam Houston, Texas 78234, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Cathartics / pharmacology*
Humans
Male
Outcome Assessment (Health Care)
Patient Satisfaction
Phosphates / pharmacology*
Polyethylene Glycols / pharmacology*
Preoperative Care / methods*
Urinary Diversion*
Chemical
Reg. No./Substance:
0/Cathartics; 0/Phosphates; 0/Polyethylene Glycols; 7632-05-5/sodium phosphate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Effective analgesia and decreased length of stay for patients undergoing radical prostatectomy: Effe...
Next Document:  Prostatic intraepithelial neoplasia in TURP specimens and subsequent prostate cancer.