Purpose: After transposition into the urinary tract, intestinal segments co
ntinue to produce mucus. We determine the effectiveness of muco-regulatory
drugs, including N-acetylcysteine, aspirin and ranitidine, in reducing mucu
s secretion and urine viscosity in patients with transposed segments.
Materials and Methods: Our trial was a prospective randomized, double-blind
placebo controlled crossover study involving 12 patients who underwent ile
al conduit and 31 who underwent bladder reconstruction, Each treatment last
ed 3 weeks with a a-week washout. Pretreatment and posttreatment 24-hour ur
ine samples were analyzed for mucin and viscosity after papain digestion, s
odium dodecyl sulfate-polyacrylamide gel electrophoresis and periodic acid-
Schiff assay. A disease specific questionnaire and SF-36 quality of life su
rvey were completed.
Results: According to the questionnaire, mucus production did not decrease
with time in 67% of patients. Mucin comprised 3% of the total nondialyzable
material in urine (65 mg./24-hour for ileal conduit and 60 mg,/24-hour for
bladder reconstruction). Analysis of questionnaires and laboratory results
failed to demonstrate any benefit of taking muco-regulatory agents compare
d with placebo.
Conclusions: The use of N-acetylcysteine, aspirin and ranitidine did not re
sult in a reduction in mucin production, urine viscosity or improvement in
quality of life.