Bladder reconstruction and urinary mucus
N'Dow JM., Pearson JP., Hayes JH., Robson WA., Sunderland AM., Neal DE.
INTRODUCTION; Following transposition into the urinary tract, intestinal segments maintain some secreto-motor function. The gut continues to secrete mucus which can result in difficulties in emptying, recurrent infection and rupture. Mucus production may decrease with time. We have investigated patients' views of urinary mucus. PATIENTS AND METHODS: We studied 31 patients following bladder reconstruction (mean follow-up M months, range 7 - 121 months) and 12 patients following ilcal conduit (follow-up 118 months, range 8 - 336 months). Patients completed a well-validated questionnaire. RESULTS: Since operalion. 67% of patients reported no reduction in mucus. 28% produced moderate or excessive mucus whilst in 47%, the amount varied from da to day; 26% produced little or no visible mucus. Forty-seven percent reported episodes of catheter or urostomy pouch blockage by mucus which occurred every day in 35%. Of patients with bladder reconstruction voiding spontaneously. 26% found that mucus intermittently obstnicted urinary flow. Urinary infection occurred in 63% who reported increased mucus associated with infection that resolved following treatment with antibiotics. Mucus production was \\orst in the morning in 67% and 40% reported an unpleasant odour attributed to mucus However, the sight of mucus in their urine did not bother most patients. About 9% regretted having had surgery because of side effects of mucus production CONCLUSION: Mucus production did not appear to the majority of patients to dimmish with time and causes significant long-term difficulties.