Evaluation of mechanical bowel preparation methods in urinary diversion surgery.

Allen F. Morey, L. Andrew Evans, R. Clayton McDonough, Alyssa M. Park, Wade J. Sexton, Joseph W Basler, Richard A. Santucci, Christopher L. Amling, Keith J. O'Reilly

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

OBJECTIVES: We performed the first prospective, randomized, multi-center comparison of overall quality and patient tolerability of polyethylene glycol (PEG) and sodium phosphate (NaP) solution for mechanical bowel preparation prior to urinary diversion surgery. METHODS: Between 2001 and 2003, 36 patients at six institutions underwent major urological reconstructive surgery incorporating small intestine (35 radical cystectomy with urinary diversion and 1 bladder augmentation). Patients were prospectively randomized to receive either oral polyethylene glycol (group 1, n = 16) or sodium phosphate (group 2, n = 20) for mechanical bowel preparation prior to surgery, according to our multi-institutional IRB-approved protocol. All patients completed a questionnaire the morning of surgery to assess the tolerability and side effects of each agent. Quality of the bowel preparation was recorded based on intraoperative findings of the attending surgeon, who was blinded to the preparation method. RESULTS: Both bowel cleansing regimens were safe and well tolerated. Patient-reported ease of use and subjective incidence of side effects were statistically similar in the two groups, and a statistically non-significant trend to more bloating in the PEG group was also noted (p = 0.085). Surgeon-scored overall quality of preparation adequacy revealed no significant differences between oral sodium phosphate and polyethylene glycol solutions (p = 0.555). Postoperative complications were rare for each bowel preparation agent. CONCLUSIONS: Performance characteristics of oral sodium phosphate and polyethylene glycol bowel preparations appear to be similar. Each method is safe, efficacious, and well-tolerated when used prior to urinary diversion surgery. The cost for the NaP preparation was $1.40 versus $19.70 for the PEG bowel preparation. Sodium phosphate may have a slight advantage because of its convenience and economic advantage.

Original languageEnglish (US)
Pages (from-to)3250-3254
Number of pages5
JournalThe Canadian journal of urology
Volume13
Issue number5
StatePublished - Oct 2006
Externally publishedYes

Fingerprint

Urinary Diversion
Reconstructive Surgical Procedures
Cathartics
Cystectomy
Research Ethics Committees
Small Intestine
Urinary Bladder
Economics
sodium phosphate
Costs and Cost Analysis
Incidence

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Morey, A. F., Evans, L. A., McDonough, R. C., Park, A. M., Sexton, W. J., Basler, J. W., ... O'Reilly, K. J. (2006). Evaluation of mechanical bowel preparation methods in urinary diversion surgery. The Canadian journal of urology, 13(5), 3250-3254.

Evaluation of mechanical bowel preparation methods in urinary diversion surgery. / Morey, Allen F.; Evans, L. Andrew; McDonough, R. Clayton; Park, Alyssa M.; Sexton, Wade J.; Basler, Joseph W; Santucci, Richard A.; Amling, Christopher L.; O'Reilly, Keith J.

In: The Canadian journal of urology, Vol. 13, No. 5, 10.2006, p. 3250-3254.

Research output: Contribution to journalArticle

Morey, AF, Evans, LA, McDonough, RC, Park, AM, Sexton, WJ, Basler, JW, Santucci, RA, Amling, CL & O'Reilly, KJ 2006, 'Evaluation of mechanical bowel preparation methods in urinary diversion surgery.', The Canadian journal of urology, vol. 13, no. 5, pp. 3250-3254.
Morey AF, Evans LA, McDonough RC, Park AM, Sexton WJ, Basler JW et al. Evaluation of mechanical bowel preparation methods in urinary diversion surgery. The Canadian journal of urology. 2006 Oct;13(5):3250-3254.
Morey, Allen F. ; Evans, L. Andrew ; McDonough, R. Clayton ; Park, Alyssa M. ; Sexton, Wade J. ; Basler, Joseph W ; Santucci, Richard A. ; Amling, Christopher L. ; O'Reilly, Keith J. / Evaluation of mechanical bowel preparation methods in urinary diversion surgery. In: The Canadian journal of urology. 2006 ; Vol. 13, No. 5. pp. 3250-3254.
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