1887

Abstract

SUMMARY

There is known to be a high risk of malignancy at uretero-colic anastomoses and it has been postulated that bacteria catalyse both the local formation and the activation of carcinogens such as N-nitrosamines. If this theory is correct, then the risk of malignancy should be greatest when the prevalence of mixed urinary tract infection is greatest.

Bacterial culture was performed on samples of urine obtained from 56 patients with three forms of urinary tract diversion: ureterosigmoidostomy, isolated ileal and colon conduits. As expected, the rectal urine of all patients with a ureterosigmoidostomy had a rich bacterial flora. However, 11 of the 15 patients with ileal conduits (73%) had significant mixed growths of bacteria in the loop urine, whereas only six out of 16 colon loop urines (37.5%) were infected, all being monobacterial infections. The implications of these bacteriological findings for carcinogenesis associated with urinary diversion are discussed.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/00222615-16-2-221
1983-05-01
2023-02-01
Loading full text...

Full text loading...

/deliver/fulltext/jmm/16/2/medmicro-16-2-221.html?itemId=/content/journal/jmm/10.1099/00222615-16-2-221&mimeType=html&fmt=ahah

References

  1. Althausen A. F., Hagen-Cook K., Hendren W. H. 1978; Non-refluxing colon conduit: experience with 70 cases. Journal of Urology 120:35–39
    [Google Scholar]
  2. Altwein J. E., Jonas U., Hohenfellner R. 1977; Long-term follow-up of children with colonic conduit urinary diversion and ureterosigmoidostomy. Journal of Urology 118:832–836
    [Google Scholar]
  3. Bergman B. 1978; Studies on patients with ileal conduit diversion with special regard to renal infection. Scandinavian Journal of Urology and Nephrology Suppl 47:1–32
    [Google Scholar]
  4. Borriello S. P., Hudson M. J., Hill M. J. 1978; Investigation of the gastrointestinal bacterial flora. Clinics in Gastroenterology 7:329–349
    [Google Scholar]
  5. Bricker E. M. 1950; Bladder substitution after pelvic evisceration. Surgical Clinics of North America 30:1511–1521
    [Google Scholar]
  6. Corbett C. R., Lloyd-Davies R. W. 1976; Long term survival after urinary diversion. A reappraisal of ureterosigmoidostomy. European Urology 2:221–225
    [Google Scholar]
  7. Crowther J. S. 1971; Transport and storage of faeces for bacteriological examination. Journal of Applied Bacteriology 34:477–483
    [Google Scholar]
  8. Dunn M., Roberts J. B., Smith P. J., Slade N. 1979; The long term results of ileal conduit urinary diversion in children. British Journal of Urology 51:458–461
    [Google Scholar]
  9. Elder D. D., Moisey C. U., Rees R. W. M. 1979; A long-term follow-up of the colonic conduit operation in children. British Journal of Urology 51:462–465
    [Google Scholar]
  10. Hicks R. M., Walters C. L., Elsebai I., El Aasser A.-B., El Merzabini M., Gough T. A. 1977; Demonstration of nitrosamines in human urine: preliminary observations on a possible etiology for bladder cancer in association with chronic urinary tract infections. Proceedings of the Royal Society of Medicine 70:413–417
    [Google Scholar]
  11. Leadbetter W. F., Clarke B. G. 1955; Five years experience with uretero-enterostomy by the “combined” technique. Journal of Urology 73:67–82
    [Google Scholar]
  12. Meynell G. G., Meynell E. 1970; Theory and practice in experimental bacteriology. 2nd ed Cambridge University Press; Cambridge:
    [Google Scholar]
  13. Mogg R. A. 1965; The treatment of neurogenic urinary incontinence using the colonic conduit. British Journal of Urology 37:681–686
    [Google Scholar]
  14. Richie J. P., Skinner D. G. 1975; Urinary diversion: the physiological rationale for the non-refluxing colonic conduits. British Journal of Urology 47:269–275
    [Google Scholar]
  15. Shousha S., Scott J., Polak J. 1978; Ileal loop carcinoma after cystectomy for bladder exstrophy. British Medical Journal 2:397–398
    [Google Scholar]
  16. Stewart M., Hill M. J., Pugh R. C. B., Williams J.P. 1981; The role of N-nitrosamine in carcinogenesis at the ureterocolic anastamosis. British Journal of Urology 53:115–118
    [Google Scholar]
  17. Stewart W.W., Cass A. S., Matsen J. M. 1979; Bacteriuria with intestinal loop urinary diversion in children. Journal of Urology 122:528–531
    [Google Scholar]
  18. Stiles H. J. 1911; Epispadias in the female and its surgical treatment with a report of 2 cases. Surgery, Gynecology and Obstetrics 30:127–140
    [Google Scholar]
  19. Wear J. B., Barquin O. P. 1973; Ureterosigmoidostomy: long term results. Urology 1:192–200
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/00222615-16-2-221
Loading
/content/journal/jmm/10.1099/00222615-16-2-221
Loading

Data & Media loading...

Most cited this month Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error