Skeletal growth and long-term bone turnover after enterocystoplasty in a chronic rat model
Article first published online: 23 JUL 2003
Volume 92, Issue 3, pages 306–313, August 2003
How to Cite
Gerharz, E.W., Gasser, J.A., Mosekilde, L., Moniz, C., Sitter, H., Barth, P.J., Thomsen, J.S., Ransley, P.G., Riedmiller, H. and Woodhouse, C.R.J. (2003), Skeletal growth and long-term bone turnover after enterocystoplasty in a chronic rat model. BJU International, 92: 306–313. doi: 10.1046/j.1464-410X.2003.04327.x
- Issue published online: 23 JUL 2003
- Article first published online: 23 JUL 2003
- Accepted for publication 14 March 2003
- bone metabolism;
- urinary diversion;
- deoxypyridinium crosslinks;
- dual energy X-ray absorptiometry;
- peripheral quantitative CT
To investigate skeletal growth and bone metabolism in a chronic animal model of urinary diversion.
MATERIALS AND METHODS
Young male Wistar rats (120) were allocated randomly to four groups undergoing: ileocystoplasty, ileocystoplasty and resection of the ileocaecal segment, colocystoplasty, and controls. All animals received antibiotics for 1 week after surgery; half of each group remained on oral antibiotics. Bone-related biochemistry was measured in serum and urine. Dual-energy X-ray absorptiometry and peripheral quantitative computed tomography (pQCT) were used to determine bone mass ex vivo.
Most (90%) of the rats survived the study period (8 months); six rats died from bowel obstruction at the level of the entero-anastomosis and four had to be killed because of persistent severe diarrhoea. Vital intestinal mucosa was found in all augmented bladders. There were no differences in bone length and volume. Loss of bone mass was almost exclusively in rats with ileocystoplasty and resection of the ileocaecal segment (−37.5%, pQCT, P < 0.01). There was no hyperchloraemic metabolic acidosis or gross impairment of renal function. Hypomagnesaemia, hypocalcaemia and decreased insulin-like growth factor-binding protein 3 were the only significant findings on blood analysis. Deoxypyridinoline crosslinks in urine were higher in rats with an enterocystoplasty than in controls.
Enterocystoplasty in rats neither impairs skeletal growth nor bone quantity, but leads to significant loss of bone mass when combined with resection of the ileocaecal segment. Rarefaction of the trabecular network is confined to the metabolically highly active cancellous compartment, most likely as a consequence of intestinal malabsorption.