PMID: 3765222Jul 1, 1986Paper

Cancer induction by urinary drainage or diversion through intestinal segments?

Der Urologe. Ausg. A
R HarzmannP Carl

Abstract

Since the introduction of ureterosigmoidostomy 79 cases of adenocarcinomas of the sigmoid near the implantation site of the ureters were described. Clinical and experimental data indicate that the excretion of urine and faeces together leads to endogenous nitrosamine synthesis and thus induces carcinomas. Other factors--like carcinogens excreted with the urine or chronic irritation of the mucosa by urine--could also cause carcinomas in the urine diverting parts of the intestine. Based on our own cases and a study of the literature we investigated whether other forms of urinary diversion can induce tumors. So far 4 tumor cases in ileum conduits and 2 cases in colon conduits have been reported together with 2 tumors in bladder augmentation (ileocystoplasty). We found in our material 1 case of cancer in a rectum bladder, 1 in a colocystoplasty, and 2 after ureterosigmoidostomy. In ureter substitution plasty and following Kock- or Camey-technique no cases of tumor induction have been reported so far. From the presently available data it must be concluded that urinary diversion using intestine may cause tumor induction. With the interval between surgery and evidence of tumor being at least 20 years a sharp increase in morbidity must...Continue Reading

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