[Long-term followup of water and solute metabolism in intestinal urinary diversion and the effect of diuresis; a 4-years observation in a unilateral ileal conduit model in dog].

PURPOSE

An intestinal segment interposed in the urinary tract can influence the water-solute balance of the patients with urinary diversion. It seems necessary to know whether such influence is changeable with the lapse of time and is also important to know whether diuresis is beneficial or not to minimize the effect of intestinal urinary diversion.

MATERIALS & METHODS: In 8 female mongrel dogs a unilateral ileal conduit urinary diversion was constructed in the right nephroureteral units using a 20 cm segment of the ileum. After two months, separate urine for exactly 3 hours was collected from the conduit stoma and the bladder catheter, and analysis was made on each solute in the urine. In 4 dogs surviving for 4 years with stable renal function the examinations were repeated to compare with previous results. Furthermore, the effect of diuresis on the water and solute excretion was examined using 6 dogs.

RESULTS

Water was reabsorbed or excreted from the ileal conduit according to the osmolality of the urine. No significant change was observed 4 years after operation. Urinary solute excretion and osmolality of the diverted side were always lower than those of intact side throughout the period. Creatinine clearance was not influence by the interposition of an ileal segment in the urinary tract in any periods. Excretion of water and reabsorption of solute was accelerated under oliguric condition and significant reabsorption of creatinine was observed in this condition.

CONCLUSION

In the experimental observation using canine model with unilateral ileal conduit urinary diversion no significant differences were observed in water and solute metabolism between the early period and 4 years after operation. Diuresis appeared to be favorable to minimize the reabsorption of urinary solute from the ileal conduit.