Abstract
The guideline of the "Deutsche Gesellschaft für Urologie" recommends capillary blood gas analysis for neobladder patients every 3 months. In case of chronic metabolic acidosis (CMS), treatment with oral bicarbonate is recommended. However, it is unknown how these recommendations are implemented in daily practice. The aim of this study was to evaluate the current diagnosis, rating and therapy of CMA among neobladder patients by German urologists. A survey covering diagnosis, rating, and therapy of CMA was sent to 5,539 urologists in Germany in August 2013. All 350 (6.3%) completed surveys were analyzed. Nearly all respondents (98%) perform blood gas analysis (BGA) to diagnose CMA, usually following unspecific symptoms such as general discomfort and fatigue. In addition, about half of the urologists frequently check their neobladder patients for CMA, regardless of any symptoms. The incidence of CMA directly following neobladder construction was estimated to be 64%. Approximately 17% of all patients need permanent CMA treatment. Ninety nine percent of all respondents prefer to treat CMA with oral bicarbonate at a daily dose of 1000-3000 mg, mostly with enteric coated formulations. CMA is an important comorbidity after neobladder construction. Furthermore, the respondents of the survey expressed great interest in receiving medical education regarding the management of CMA in neobladder patients.
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