Van der Aa Frank, Joniau Steven, Van Den Branden Marcel, Van Poppel Hein
Department of Urology, University Hospitals Leuven, B-3000 Leuven, Belgium.
Adv Urol. 2011;2011:764325. doi: 10.1155/2011/764325. Epub 2011 May 12.
Urinary diversion is performed on a regular basis in urological practice. Surgeons tend to underestimate the metabolic effects of any type of diversion. From the patient's perspective, diarrhea is the most bothersome complaint after urinary diversion. This might be accompanied by malabsorption syndromes, such as vitamin B12 deficiency. Electrolyte abnormalities can occur frequently such as hyperchloremic metabolic acidosis, or less frequently such as hypokalemia, hypocalcaemia, and hypomagnesaemia. Bone health is at risk in patients with urinary diversion. Some patients might benefit from vitamin D and calcium supplementation. Many patients are also subject to urinary calculus formation, both at the level of the upper urinary tract as in intestinal reservoirs. Urinary diversion can affect hepatic metabolism, certainly in the presence of urea-splitting bacteria. The kidney function has to be monitored prior to and lifelong after urinary diversion. Screening for reversible causes of renal deterioration is an integral part of the followup.
尿流改道在泌尿外科实践中经常进行。外科医生往往低估任何类型改道的代谢影响。从患者的角度来看，腹泻是尿流改道后最困扰人的主诉。这可能伴有吸收不良综合征，如维生素B12缺乏。电解质异常可能经常发生，如高氯性代谢性酸中毒，或较少见的低钾血症、低钙血症和低镁血症。尿流改道患者的骨骼健康面临风险。一些患者可能受益于维生素D和钙补充剂。许多患者还容易在上尿路水平以及肠道贮尿囊处形成尿路结石。尿流改道会影响肝脏代谢，尤其是在存在尿素分解细菌的情况下。在尿流改道之前和之后的终身都必须监测肾功能。筛查肾脏恶化的可逆原因是随访的一个组成部分。
