MP41-05 ASSESSING THE INCIDENCE, TIMING, AND RISK FACTORS FOR VITAMIN B12 DEFICIENCY FOLLOWING CYSTECTOMY WITH URINARY DIVERSION

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Ureter (including Pyeloplasty) and Bladder Reconstruction (including fistula), Augmentation, Substitution, Diversion I (MP41)1 Apr 2020MP41-05 ASSESSING THE INCIDENCE, TIMING, AND RISK FACTORS FOR VITAMIN B12 DEFICIENCY FOLLOWING CYSTECTOMY WITH URINARY DIVERSION William Boysen*, Yuan Wu, Leah Davis, and Andrew C. Peterson William Boysen*William Boysen* More articles by this author , Yuan WuYuan Wu More articles by this author , Leah DavisLeah Davis More articles by this author , and Andrew C. PetersonAndrew C. Peterson More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000890.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The use of ileum for urinary diversion following cystectomy is standard in modern practice, but the impact on B12 absorption remains unclear. Cases of symptomatic B12 deficiency following urinary diversion are rare, but many centers routinely monitor B12 levels in patients with urinary diversions. We sought to characterize the incidence and timing of B12 deficiency among patients with urinary diversions in our large institutional series. METHODS: With IRB approval, we queried our institutional electronic health record for all patients who underwent cystectomy with urinary diversion between 12/1997 and 10/2018. Patients under age 18 or without 1 year follow up were excluded. Demographics, diversion type, and B12 assays were collected. B12 deficiency was defined as a value under 300 ng/L. Descriptive statistics as well as univariable and multivariable logistic regression analysis were performed. RESULTS: A total of 1228 patients underwent cystectomy with urinary diversion Of those, 856 (69.7%) had >=1 year follow up, with median follow up of 16 months (IQR 15-41). The majority of patients were male (71.4%) and Caucasian (83.5%), with median BMI of 27.1 (IQR 24.1-30.4). B12 monitoring was performed in 299 (34.9%), and B12 deficiency developed in 149 patients (49.8%) at a median time of 10 (IQR 3-24) months post-urinary diversion. Those who developed B12 deficiency were younger at time of cystectomy (age 62.5 yrs versus 66.4, p=0.003) and were more likely to have undergone a continent diversion (19.5% vs 10.7%, p=0.049). Gender, race, and BMI did not differ between the groups. On univariable analysis, lower age decreased the odds of developing B12 deficiency (OR 0.97 95%CI 0.95-0.99 p=0.002) while continent diversion increased odds of B12 deficiency (OR 2.02 95% CI 1.06-3.99 p=0.04). On multivariable analysis, these relationships were no longer significant but female gender increased the odds of B12 deficiency (OR 2.17, p=0.038, Table 1). CONCLUSIONS: In this large institutional series, B12 monitoring was performed infrequently but B12 deficiency was common. Female gender increases the odds of developing B12 deficiency. Routine screening of patients for B12 deficiency following urinary diversion is warranted, with particular attention to females and those with continent diversion. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e596-e597 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information William Boysen* More articles by this author Yuan Wu More articles by this author Leah Davis More articles by this author Andrew C. Peterson More articles by this author Expand All Advertisement PDF downloadLoading ...