Cobalamin profiles in patients after urinary diversion.

Abstract

We assessed the risk of tissue cobalamin (vitamin B12) deficiency in patients after various types of urinary diversion. Serum vitamin B12, methylmalonic acid and homocysteine were measured in 41 patients with urinary diversion, including an ileal neobladder in 12, ileal reservoir in 2, ileocecal reservoir in 10 and ileal conduit in 17. Followup was 0 to 10 years. The complete cobalamin profiles revealed a much higher incidence of tissue cobalamin deficiency in patients with each type of urinary diversion than measuring the vitamin B12 level alone. The risk of chronic tissue cobalamin deficiency after urinary diversion is higher than previously reported based on measuring serum vitamin B12 alone. Long-term patient monitoring for cobalamin deficiency or empirical supplemental therapy is indicated to prevent clinical cobalamin deficiency and irreversible sequelae.