Document Detail


Skeletal health after intestinal bladder augmentation: findings in 54 patients.
MedLine Citation:
PMID:  17662076     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the risk of osteopenia in patients after intestinal bladder augmentation. PATIENTS AND METHODS: In all, 54 patients with bladder augmentation were evaluated during the regular follow-up programme. Augmentation was performed because of paediatric neurogenic or non-neurogenic reasons. Areal bone mineral densities (aBMD) for the lumbar spine (L1-L4), femoral neck and whole body were measured with dual-energy X-ray absorptiometry. In addition, acid-base balance and plasma 25-hydroxyvitamin D (vitamin D), kidney and gonadal functions as well as body mass index (BMI) were measured. Findings were correlated with clinical characteristics. RESULTS: BMD was reduced in 34 (63%) of the 54 patients. There was a significant difference in the prevalence of decreased aBMDs between neurogenic and non-neurogenic groups 31 of 42 patients (74%) and three of 12 patients, respectively (P < 0.01). There were spinal compression fractures in 23% of patients. Risk factors for osteoporosis were inability to walk, renal insufficiency, hypogonadism, vitamin D deficiency, acidosis, and a low BMI. There was moderate or severe vitamin D deficiency in 42% of patients but the vitamin D status did not correlate with BMD. The glomerular filtration rate correlated to the whole-body aBMD (P = 0.04). In 26% of patients (predominantly males with myelomeningocele) plasma follicle-stimulating hormone levels were elevated, indicating variable degrees of hypogonadism. Hypogonadism was associated with reduced lumbar spine aBMD (P = 0.03). CONCLUSION: Patients with paediatric reasons for bladder augmentation are at risk of osteopenia and compression fractures. The risk factors are mostly related to the patient's underlying illness and not to the augmentation per se.
Authors:
Seppo Taskinen; Riitta Fagerholm; Outi Mäkitie
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Publication Detail:
Type:  Journal Article     Date:  2007-07-23
Journal Detail:
Title:  BJU international     Volume:  100     ISSN:  1464-4096     ISO Abbreviation:  BJU Int.     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-09-07     Completed Date:  2007-11-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100886721     Medline TA:  BJU Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  906-10     Citation Subset:  IM    
Affiliation:
Hospital for Children and Adolescents, Division of Surgery, Helsinki University Hospital, Helsinki, Finland. seppo.taskinen@hus.fi
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MeSH Terms
Descriptor/Qualifier:
Absorptiometry, Photon
Adolescent
Adult
Bladder Exstrophy / complications,  surgery*
Bone Density / physiology*
Bone Diseases, Metabolic / etiology*,  prevention & control,  radiography
Child
Child, Preschool
Female
Fractures, Bone / etiology*,  prevention & control,  radiography
Glomerular Filtration Rate / physiology
Humans
Male
Risk Factors
Vitamin D Deficiency / complications

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


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