Complications of Radical Cystectomy and Orthotopic Reconstruction

Figure 1

Electrolyte abnormalities in patients with ileal and/or colonic OBS. (1) absorption from urine which dissociates to H⁺ and NH₃ resulting in metabolic acidosis. (2) Cl⁻ is exchanged with and transported into blood. (3) Na⁺ is displaced by and not absorbed by bowel resulting in a net loss. (4) There is a net loss of H₂O resulting in dehydration and loss of Na⁺ due to NB secretion of Na⁺ into urine. (5) Elevated aldosterone levels due to Na⁺ loss precipitates K⁺ loss from renal tubules. Na⁺: sodium; K⁺: potassium; : ammonium; NH₃: ammonia; : bicarbonate; H⁺: hydrogen; H₂O: water; Cl⁻: chloride; NB: neobladder.