Changes in the Elemental Composition of Bladder Mucus in Stone and Non-Stone forming Patients following Augmentation Cystoplasty

Abstract

The incidence of bladder stones is increased by 50% following bladder augmentation(l,2). Stones require surgical removal as they are typically too large to pass. A recurrence rate of 19% has been noted(2) necessitating multiple sugical procedures. Etiology of stones in augmented bladders is due to a number of factors including foreign body reactions, metabolic abnormalities, infection and intestinal mucus. In order to determine whether the elemental composition of bladder mucus plays a role in the development of bladder calculi, energy dispersive x-ray spectrometry(EDXS) was done on the mucus from stone and non-stone forming patients. In addition, stones from the same patients were examined and analyzed and the data compared with the composition of the mucus.Eighteen patients participated in this study, 14 of whom had ileo-cystoplasties and 2 ileo-cecal augments. Two were cloacal extrophy patients where the hind gut was incorporated with the bladder halves. To avoid any foreign body reactions, metal staples were not used in any of the bladder augmentation procedures.