Vitamin B12 and folic acid plasma levels after ileocecal and ileal neobladder reconstruction

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      To compare the plasma levels of vitamin B12 and folic acid following resection of ileocecal or ileal segments used for orthotopic bladder substitution.


      Hemoglobin, hematocrit, and plasma levels of vitamin B12 and folic acid were measured in 34 patients with ileocecourethrostomy (ICUS) and in 16 patients with ileal reservoir (IR), with a mean follow-up of 59.8 ± 41.9 months. The results were compared with regard to both the type of operation and the length of time since surgery.


      The level of folic acid was normal in all patients. The mean level of vitamin B12 in the ICUS group was 413.67 ± 160.45 ng/mL compared to 257.63 ± 121.36 for the IR group. This difference was statistically significant. In the IR group, 18.75% of the patients had a level of vitamin B12 below normal.


      There is a tendency for vitamin B12 levels to fall in patients in whom the ileum is used. Resection of the ileocecal segment including the junction does not alter the level of vitamin B12.
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        • Alcini E
        • Vincenzoni M
        • Destito A
        • D'Addessi A
        • Castiglioni GC
        Ileocaecourethroplasty after total cystectomy for bladder cancer.
        Br J Urol. 1985; 57: 160-163
        • Alcini E
        • Pescatori M
        • D'Addessi A
        • Grassetti F
        • Anastasio G
        • Giustacchini M
        • Grasso G
        Multiple taeniamyotomies of the replaced caecum after restorative cystoprostatovesiculectomy for bladder cancer.
        Br J Urol. 1990; 66: 441-442
        • Alcini E
        • Pescatori M
        • D'Addessi A
        • Destito A
        • Castiglioni GC
        Bladder reconstruction after cystectomy for cancer: use of the ileal reservoir.
        Br J Urol. 1985; 57: 245-247
        • Matsui U
        • Topoll B
        • Miller K
        • Hautmann RE
        Metabolic long-term follow-up of the ileal neobladder.
        Eur Urol. 1993; 24: 197-200
        • Stein R
        • Lotz J
        • Fish M
        • Beetz R
        • Prellwitz W
        • Hohenfellner R
        Vitamin metabolism in patients with a Mainz pouch I: Long-term followup.
        J Urol. 1997; 157: 44-47
        • Jahnson S
        • Pedersen J
        Cystectomy and urinary diversion during twenty years—complications and metabolic implications.
        Eur Urol. 1993; 24: 343-349
        • Pannek J
        • Haupt G
        • Schulze H
        • Senge T
        Influence of continent ileal urinary diversion on vitamin B12 absorption.
        J Urol. 1996; 155: 1206-1208
        • Ben-Chaim J
        • Shenfeld O
        • Goldwasser B
        • Shemesh E
        Does the use of the ileocecal region in reconstructive urology cause persistent diarrhea?.
        Eur Urol. 1995; 27: 315-318
        • Rogers ACN
        • Steyn JH
        Vitamin B12 absorption in patients with ileal resection.
        Br J Urol. 1974; 46: 625-629
        • Hautman RE
        • Egghard G
        • Frohneberg D
        • Miller K
        The ileal neobladder.
        J Urol. 1988; 139: 39-42
        • Rogers E
        • Scardino PT
        A simple ileal substitute bladder after cystectomy: experience with a modification of the Studer pouch.
        J Urol. 1995; 153: 1432-1438
        • Studer UE
        • Danuser H
        • Hochreiter W
        • Springer JP
        • Turner WH
        • Zingg EJ
        Summary of 10 years' experience with an ileal low-pressure bladder substitute combined with an afferent tubular isoperistaltic segment.
        World J Urol. 1996; 14: 29-39
        • Davidsson T
        • Lindergrd B
        • Mnsson W
        Longterm metabolic and nutritional effects of urinary diversion.
        Urology. 1995; 46: 804-809
        • Narayan P
        • Broderick GA
        • Tanagho A
        Bladder substitution with ileocaecal (Mainz) pouch. Clinical performance over 2 years.
        Br J Urol. 1991; 68: 588-595
        • Kolettis PN
        • Klein EA
        • Nowick AC
        • Winters JC
        • Appell RA
        The Le Bag orthotopic urinary diversion.
        J Urol. 1996; 156: 926-930
        • Steiner MS
        • Morton RA
        • Marshall FF
        Vitamin B12 deficiency in patients with ileocolic bladder.
        J Urol. 1993; 149: 255-257
        • Canning DA
        • Perman JA
        • Jeffs RD
        • Gearhart JP
        Nutritional consequences of bowel segments in the lower urinary tract.
        J Urol. 1989; 142 (2 Pt2): 509-511
        • Kinn AC
        • Lantz B
        Vitamin B12 deficiency after irradiation for bladder carcinoma.
        J Urol. 1984; 131: 888-890
        • Mappes C
        • Fish M
        • Stein R
        • Doi Y
        • Matani Y
        • Stöckle M
        • Hohenfellner R
        La poche iléo-c˦cale continente. Poche de Mainz I.
        Ann Urol. 1995; 29: 232-237