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  Table of Contents 
LETTER TO EDITOR
Year : 2023  |  Volume : 39  |  Issue : 1  |  Page : 82-83
 

Author Reply Re. Mandhani A. The paradox of why and how in urology! Indian J Urol 2022;38:247-8


Department of Urology and Kidney Transplant, Fortis Memorial Research Institute, Gurugram, Haryana, India

Date of Submission28-Nov-2022
Date of Acceptance08-Dec-2022
Date of Web Publication29-Dec-2022

Correspondence Address:
Anil Mandhani
Department of Urology and Kidney Transplant, Fortis Memorial Research Institute, Gurugram, Haryana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/iju.iju_410_22

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How to cite this article:
Mandhani A. Author Reply Re. Mandhani A. The paradox of why and how in urology! Indian J Urol 2022;38:247-8. Indian J Urol 2023;39:82-3

How to cite this URL:
Mandhani A. Author Reply Re. Mandhani A. The paradox of why and how in urology! Indian J Urol 2022;38:247-8. Indian J Urol [serial online] 2023 [cited 2023 Jan 28];39:82-3. Available from: https://www.indianjurol.com/text.asp?2023/39/1/82/365902


We appreciate the honest acknowledgment of our thoughts by the authors and, at the same time, agree to some extent that scientifically, the statement on the bladder mucosa should have carried the sentiments in the letter and not just in spirit.

The purpose of the editorial was not to belittle the evolution in the research for urinary diversion or any other field in urology, but was to extort ourselves to follow the right direction of making better use of time spent in meetings. We need a more critical appraisal to weed out notional geocentric thought processes prevailing in urological society and focus on heliocentric thought processes to benefit our patients. In that regard, information overload should be analyzed wisely for clinical relevance by encouraging prodigies like Nicolaus Copernicus.

It is true that bladder mucosa is not a nonabsorptive surface, but it is a well-known fact that the degree of severity of metabolic complications after the neobladder formation varies according to the type of bowel segment used. Chronic acid load due to bowel interposition is due to the absorption of ammonia, hydrogen, and chloride, which does not happen with normal bladder mucosa.[1] Abnormal drug kinetics and problems related to reabsorption in people with diabetes and in patients with compromised renal function are attributed to the ileum only.[1]

The gold standard surgical treatment for urinary diversion has reached its threshold and falls short of providing functional results akin to the natural bladder and the thoughts in the editorial on bladder mucosa are consistent with the great research work on the regenerative bladder to restore normalcy.[2]

We are not Luddite and would love to see the progress in science, but the idea was to nudge the ill-directed intelligentsia in various urological societies to stay away from one-upmanship and work together to look for better options to achieve the best functional outcomes for various diseases in urology.

Financial support and sponsorship: Nil.

Conflicts of interest: There are no conflicts of interest.

 
   References Top

1.
Winter A, Dahl DM. Use of intestinal segments in urinary diversion. In: Campbell-Walsh-Wein. Philadelphia: Saunders Elsevier; 2021. p. 3160-205.  Back to cited text no. 1
    
2.
Adamowicz J, Pokrywczynska M, Van Breda SV, Kloskowski T, Drewa T. Concise review: Tissue engineering of urinary bladder; we still have a long way to go? Stem Cells Transl Med 2017;6:2033-43.  Back to cited text no. 2
    




 

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