Objective: To study the local host response in patients with colonic and ileal neobladders, with or without bacteriuria.
Methods: Twenty-three patients with colonic neobladders and 19 with ileal neobladders were included. Eleven radical prostatectomy patients and seven healthy male volunteers were used as controls. Six urine samples were obtained from all patients and controls over a six-month period. The samples were cultured semiquantitatively, and the number of neutrophils and concentrations of the inflammatory mediators interleukin 6 and 8 (IL-6, IL-8) in the urine were determined.
Results: The prostatectomy patients and healthy volunteers had sterile urine, and concentrations of IL-6 and IL-8 were below the detection limit. Most (>70%) of the urine samples from patients with colonic and ileal neobladders showed anaerobic or aerobic bacterial growth, and uropathogens were identified in about 45% of the samples. The local host response was minimal or undetectable in the sterile urine samples. However, the host response was markedly induced by uropathogenic strains in the urine, but not by urinary carriage of nonpathogenic or anaerobic strains. IL-8, but not IL-6, was increased in colonic neobladders, which corresponds to the mucosal host responses in patients with intact lower urinary tracts and asymptomatic bacteriuria. In ileal neobladders, the IL-8 responses were higher, and levels of IL-6 were significantly increased.
Conclusion: Neobladders exhibit a significant local host response to colonization with bacterial uropathogens. This reaction is more pronounced and includes IL-6 activation in ileal neobladders than in colonic neobladders.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.eururo.2006.02.012 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The incidence and risk factor for febrile urinary tract infection after robot-assisted laparoscopic radical cystectomy in bladder cancer patients.
J Infect Chemother
January 2025
Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan.
Introduction: Febrile urinary tract infections are major complications of radical cystectomy; however, their characteristics after robot-assisted radical cystectomy remain unclear. Thus, we investigated the rate, severity, pathogens, and risk factors of febrile urinary tract infections after robot-assisted radical cystectomy.
Patients And Methods: Patients who underwent robot-assisted radical cystectomy at three institutions between April 2018 and March 2022 were retrospectively analyzed.
Bowel regimens before radical cystectomy: An analysis of a modern cohort.
Int J Urol
January 2025
Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Introduction: Bowel regimens (BR) before radical cystectomy (RC) are currently not recommended by Enhanced Recovery After Surgery (ERAS) protocols, as prior studies have shown BRs lead to worsened outcomes. However, many of those studies have used historic literature before recent surgical advancements such as minimally invasive RC and have not investigated the impact BRs have by type of urinary diversion. Our goal is to determine the outcomes of preoperative BR in patients undergoing RC based on diversion type using a modern patient cohort.
View Article and Find Full Text PDFUrinary Diversion Versus Adverse In-Hospital Outcomes After Radical Cystectomy.
Ann Surg Oncol
December 2024
Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada.
Objective: This study aimed to compare adverse in-hospital outcomes in ileal conduit versus neobladder urinary diversion type after radical cystectomy (RC) in contemporary versus historical patients.
Methods: Patients were identified within the National Inpatient Sample (NIS 2000-2019). Propensity score matching (PSM; 1:2 ratio) and multivariable logistic regression models (LRMs) were used.
Pure open versus robotic radical cystectomy with intracorporeal urinary diversion: a propensity matched analysis.
World J Urol
December 2024
Department of Urology, Bichat Claude Bernard Hospital, Paris Cité University, 46 rue Henri Huchard, Paris, 75018, France.
Objective: To compare surgical parameters and short-term outcomes between open radical cystectomy (ORC) and robotic radical cystectomy with total intracorporeal urinary diversion (icRARC).
Methods: Among the study period, 133 patients who underwent ORC and pelvic node dissection for bladder cancer (group 1) were matched and compared to 61 patients who underwent icRARC during the same period (group 2). The groups were matched 1:1 according to their propensity scores adjusted on their baseline demographics and disease characteristics.
A large vaginal stone on top of ureteric stent migration through a poucho-vaginal fistula after radical cystectomy and ileal neobladder reconstruction - A case report.
Int J Surg Case Rep
December 2024
Radiology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Introduction And Importance: Orthotopic neobladder reconstruction may be associated with complications such as neobladder-vaginal fistula (NVF) and uretero-ileal anastomotic stricture which are often managed using stents, though these can be prone to migration.
Case Presentation: We present a 69-year-old lady with a surgical history of radical cystectomy and ileal neobladder that was complicated by a left ureteric stricture and poucho-vaginal fistula for which she underwent a left ureteric stent and bilateral percutaneous nephrostomy (PCN) insertions after which she lost to follow-up. The patient later presented to our center with a right subcostal anterior abdominal wall desmoid tumor for which she underwent wide local excision.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!