Secondary Tumors After Urinary Diversion

Donor-derived duodenal adenocarcinoma of a bladder-drained pancreas allograft

“…A study of 17,758 patients with urinary diversions at 44 German centers revealed a 1.71% tumor incidence in patients with prior ileocystoplasties, all of which were adenomas or adenocarcinomas of the ileal segment or the ileovesical anastomotic junction 10 . Their observed mean latency period of 21.5 years is consistent with the broader literature 11 . These rates are contrasted with the lower lifetime incidence of small bowel adenocarcinoma which is estimated at 0.3% 13 .…”

“…10 Their observed mean latency period of 21.5 years is consistent with the broader literature. 11 These rates are contrasted with the lower lifetime incidence of small bowel adenocarcinoma which is estimated at 0.3%. 13 Other forms of urinary diversion using isolated bowel without native bladder such as ileal conduits, ileal neobladders and ileocecal pouches have not demonstrated the same risk of carcinogenesis.…”

“…In urology, gastrointestinal tract is used to replace or augment dysfunctional ureters and bladders or to create new urinary diversion after cystectomy. Ureterosigmoidostomy was once the most common form of urinary diversion, however it fell out of favor after it became apparent that 2%–15% of patients develop colonic adenocarcinomas at the ureterosigmoid junction 20–26 years later 11,12 . Augmentation cystoplasty, in which bladder volume and compliance is increased through anastomosis of a detubularized gastrointestinal segment, has also been associated with tumor risk.…”

“…9 Studies in the urologic literature have assessed malignancy risk after urinary reconstruction with gastrointestinal segments. 10,11 In urology, gastrointestinal tract is used to replace or augment dysfunctional ureters and bladders or to create new urinary diversion after cystectomy. Ureterosigmoidostomy was once the most common form of urinary diversion, however it fell out of favor after it became apparent that 2%-15% of patients develop colonic adenocarcinomas at the ureterosigmoid junction 20-26 years later.…”

“…Ureterosigmoidostomy was once the most common form of urinary diversion, however it fell out of favor after it became apparent that 2%-15% of patients develop colonic adenocarcinomas at the ureterosigmoid junction 20-26 years later. 11,12 Augmentation cystoplasty, in which bladder volume and compliance is increased through anastomosis of a detubularized gastrointestinal segment, has also been associated with tumor risk. A study of 17,758 patients with urinary diversions at 44 German centers revealed a 1.71% tumor incidence in patients with prior ileocystoplasties, all of which were adenomas or adenocarcinomas of the ileal segment or the ileovesical anastomotic junction.…”