Study on use of isolated segment of ileum in urological plastic operation

Urinary solute transport by ileal segments. I. Effects of nicotinic acid

This study was conducted to quantify urinary solute transport by the ileum, using an in vivo human model, and to determine the effect of nicotinic acid on this process. Patients were studied under both basal conditions and niacin therapy. The rates of solute transport were established by analysis of excretion indexes for each solute. Potassium and ammonium were absorbed by the ileum, while phosphorus, sodium and bicarbonate were secreted. The percentage excretion index of sodium and bicarbonate increased by approximately 100 and 600% respectively, causing a significant rise in urinary pH. Although not statistically significant, there was a tendency for chloride to be absorbed and for water to pass into the bowel lumen. Nicotinic acid 3 g/day had no significant effect on urinary solute transport.

Osteomalacia due to ileal replacement of ureters: report of 2 cases

We report 2 cases of ileal replacement of the ureters: 1 bilateral and 1 unilateral with a single kidney. Hyperchloremic acidosis developed in both patients and osteomalacia was proved by iliac bone biopsy. Patient 1 had symptomatic bone disease and control of acidosis with sodium bicarbonate was difficult because of associated hypertension. The level of alkaline phosphatase varied inversely with the level of serum bicarbonate. Pharmacological doses of 1-alpha hydroxycholecalciferol were ineffective and osteomalacia persisted in a second biopsy. Patient 2, who was asymptomatic, suffered acidosis and increased serum alkaline phosphatase levels immediately postoperatively and osteomalacia was confirmed histologically at 6 months.

Ileal loop replacement and restoration of kidney function in extensive bilharziasis of the ureter

Ileal loop replacement is often the only possible treatment of extensive bilharziasis of the ureter. Experience with 5 such cases is presented and the special problems arising from the nature and extent of the lesion are discussed. In bilateral cases, attempts should be made to preserve as much renal tissue as possible. Non-functioning kidneys in 3 cases were not removed and a degree of function was restored following the relief of obstruction by also connecting these kidneys to the ileal loop.

Total replacement of ureter with a segment of ileum

Replacement of ureter with a segment of ileum was successfully performed in two patients. One had ureteral cancer and the other recurrent calculi due to cystinuria. The first patient had only one kidney. In the second both ureters were replaced with ileum. Formation of a papilla at the distal end of the ileal segment in the bladder may reduce the risk of vesico-ileal reflux.