Comparison of Complications in Three Incontinent Urinary Diversions

Pycha, Armin; Comploj, Evi; Martini, Thomas; Trenti, Emanuela; Mian, Christine; Lusuardi, Lukas; Lodde, Michele; Mian, Michael; Palermo, Salvatore

doi:10.1016/j.eururo.2008.04.068

Cited by 79 publications

(43 citation statements)

References 24 publications

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“…However, serious stomal problems may occur despite this, and may require stomal reconstruction with open surgery. In a study analyzing 16 months of followup for incontinent diversion methods, UCS was found to be more advantageous than ileal and colonic conduits (22). There is consensus in the literature that UD types cannot be recommended randomly to patients and that of all types of UD, UCS has the lowest surgical complication rate.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Outcomes of Patients Who Underwent Ureterocutaneostomy

Kızılay¹,

Şimşir²,

Cüreklibatir³

et al. 2018

uob

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Objective: Ureterocutaneostomy (UCS) is a urinary diversion (UD) method which is used rarely in a carefully selected patient group. In this study, we aimed to present the data and long-term outcomes of patients who underwent UCS treatment in our clinic. Materials and Methods: A total of 36 patients who underwent UCS between January 2000 and December 2017 were included in the study. All patients had unilateral or bilateral ureteral-skin anastomosis. The demographic data, diagnoses, comorbidities, side of UCS (unilateral-bilateral), anesthesia method, operation time, and complications of the patients were recorded from the hospital registry system. The complications and survival status of the patients until the study date were evaluated. The study data were presented as mean (minimum-maximum) and number (percent). Results: Mean follow-up time was 128.5 (8-192) months. The mean American Society of Anesthesiologists score was 3.25. The patients had significant comorbidities, mainly hypertension, chronic obstructive pulmonary disease, and coronary artery disease. UCS was performed most frequently after radical cystectomy due to muscle-invasive bladder tumour (75%) and was usually bilateral (75%). The most common indications for UCS were significant comorbidities (55%). Only 3 (8.33%) patients developed ureteral-skin anastomosis, 6 (16.66%) patients developed pyelonephritis, and 9 patients died during the follow-up period. Conclusion: Although UCS is not a first-line UD method, it should still be kept in mind in the 21 st century for patients unable to tolerate segment excision from the gastrointestinal tract and postoperative complications due to comorbidities.

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Section: Discussionmentioning

confidence: 99%

Long-Term Outcomes of Patients Who Underwent Ureterocutaneostomy

Kızılay¹,

Şimşir²,

Cüreklibatir³

et al. 2018

uob

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show abstract

“…In a study performed in 2008 where complications related to incontinent UDs were evaluated, extra advantages of UCN have been demonstrated over ileal, and colonic conduits during 16 months of follow-up. [9] In a more comprehensive study performed in the same year, authors reported lesser long-term complication rates for ileal conduits, when compared with all continent abdominal pouches, and orthotopic neobladder procedures. [10] Herein, our aim is to discuss justifications, and outcomes of UCN chosen as an UD procedure for our patients with various indications.…”

Section: Introductionmentioning

confidence: 99%

Ureterocutaneostomy: for whom and when?

Kozacıoğlu¹,

Değirmenci²,

Günlüsoy³

et al. 2014

Turkish Journal of Urology

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Objective: To discuss the indications and the results of the patients treated with ureterocutaneostomy (UCN) for urinary diversion in our center. Material and methods:Between March 2008 and November 2012, 27 patients (19 males and 8 females) were treated with UCN in our clinic. Patients' ages ranged between 56-78 years. Radical cystectomy was performed on 21 of these patients. The patients underwent transureteroureterostomy and UCN or unilateral or bilateral side-by-side UCN on the abdominal wall. Double-J stents were placed inside the ureters and changed every 12 weeks. Comorbidities and American Society of Anesthesiologists (ASA) scores were noted. Results:The patients had invasive bladder cancer (n=24), multiple tumors within and outside of a diverticulum and intractable recurrent bleeding (n=1), recurrent hemorrhage (n=1), and bladder contracture (n=1). As comorbidities, hypertension (n=14), chronic obstructive pulmonary disease (n=11), diabetes mellitus (n=10), coronary artery disease (n=8), chronic renal failure (n=1), and Crohn's disease (n=1) were detected. The ASA score was 3 or greater in 14 patients. During follow-up period, 3 patients experienced pyelonephritis, and one of them had a strictured ureteral orifice.Conclusion: UCN can be used as a method of urinary diversion in selected patients.

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“…However, this procedure uses intestinal segments, which is related to several major complications. 7 Therefore, in our cases we avoided urinary diversion using intestinal segments for complicated patients (i.e., advanced age, comorbidity, low performance status). The simplest alternative for permanent urinary diversion was cutaneous ureterostomy.…”

Section: Discussionmentioning

confidence: 99%

Clinical benefits of tubeless umbilical cutaneous ureterostomy

Numakura

Tsuchiya

Takahashi

et al. 2015

CUAJ

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Introduction: We assess a novel technique of tubeless bilateral cutaneous ureterostomy, with a single umbilical stoma, for bladder cancer patients with short ureters after cystectomy. The benefit of cutaneous ureterostomy is equal to other incontinent urinary diversions, when the tubeless procedure is successfully achieved. This simple technique makes it easy to monitor the upper urinary tract (UUT) and is beneficial to patients with a high risk of UUT recurrence. Methods: This old and new surgical technique was used to perform total cystectomy and urinary diversion on three patients with bladder cancer at a high risk of UUT recurrence. Results: Two men and one woman (mean age: 73 years) underwent this surgery and the mean follow-up period was 8.3 years. The surgical approaches were laparotomy (n = 2) and laparoscopy (n = 1). One case developed para-stomal erosion, whereas another developed ureteral stenosis requiring catheter reinsertion. Although postoperative hydronephrosis was observed in all cases, the mean preoperative and postoperative serum creatinine levels were 0.70 and 0.76, respectively. UUT recurrence was not observed during the follow-up period. Conclusion: This tubeless umbilical cutaneous ureterostomy procedure greatly improves the outcome of urinary diversion for cancer patients with short ureters at a high risk of UUT recurrence. The benefits are equivalent to other urinary diversions when the tubeless procedure is successfully achieved.

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Comparison of Complications in Three Incontinent Urinary Diversions

Cited by 79 publications

References 24 publications

Long-Term Outcomes of Patients Who Underwent Ureterocutaneostomy

Long-Term Outcomes of Patients Who Underwent Ureterocutaneostomy

Ureterocutaneostomy: for whom and when?

Clinical benefits of tubeless umbilical cutaneous ureterostomy

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