Surgical Complications of Urinary Diversion

Anderson, Christopher B.; McKiernan, James M.

doi:10.1016/j.ucl.2017.09.008

Cited by 40 publications

(42 citation statements)

References 80 publications

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“…No significances were found in cognitive function and overall HRQoL, confirming recent reviews on the topic [7,18]. In conjunction with the available literature, we conducted, that elderly patients usually bring along more comorbidities and therefore being offered "the easiest solution possible", the ileal conduit [2,25]. Based on these data and to further substantiate our claims that reduced dexterity or cognitive function would impair the medical care reality in the respective UDs, we found that impaired dexterity and cognitive function indeed was significantly associated with subjective constraints in stoma care, CIC, and continence.…”

Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

“…Tizzoni and Foggi [1] anastomosed an ileal loop with the bladder neck of dogs after cystectomy in 1888 and since this time, many techniques have been published reporting on experience in utilizing intestine for urinary diversion (UD) [2]. Besides wet loop diversions such as the ileal conduit, starting in the 1980s, a growing number of techniques for continent orthotopic or cutaneous UD have been established and described [2][3][4]. Long-term follow-up, for example, in the Mainz ileocecal pouch, confirmed safety and reliability of these techniques regarding complica- tions, renal function, metabolic consequences, body image, and health-related quality of life (HRQoL) measures [5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

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Cognitive Status and Functional Dexterity as Outcome Predictors Following Urinary Diversion: A Combined Retrospective and Prospective Observational Study

et al. 2018

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Purpose: The study aimed to evaluate the impact of the validated functional dexterity test and the Mini-Mental Status test on subjective functional outcomes, medical care situation, and health-related quality of life (HRQoL) after urinary diversion (UD). Patients and Methods: A total of 106 patients (n = 26 ileal conduits, n = 29 neobladders, and n = 51 ileocecal pouches) were included in this combined retrospective (n = 77) and prospective (n = 29) observational study. All patients performed the 2 tests mentioned above and filled out self-designed questionnaires with diversion and HRQoL items. In the prospective cohort, the tests were performed preoperatively and the questionnaires were filled out preoperatively as well as 3 and 6 months after surgery. Results: Reduced dexterity and cognitive skills were significantly associated with increased patient age and subjective constraints in stoma care of ileal conduits, self-catheterization in ileocecal pouches, and continence in neobladders. Overall HRQoL, however, was not affected by dexterity or cognitive measures. Conclusions: Assessing the cognitive status and functional dexterity of patients undergoing UD might provide a useful objective clinical tool to aid in decision-making regarding the type of UD and postoperative medical care situation. Further prospective data are needed to confirm these findings and further simplify the methods used here.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cognitive Status and Functional Dexterity as Outcome Predictors Following Urinary Diversion: A Combined Retrospective and Prospective Observational Study

et al. 2018

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“…paralytic ileus and adhesive intestinal obstruction) and infectious, with a reported incidence of 15%–29% and 7%–30%, respectively. Late complications include strictures, parastomal or incisional hernias, and urolithiasis . However, small bowel obstruction due to an internal hernia caused by the ureter is an extremely rare occurrence.…”

Section: Discussionmentioning

confidence: 99%

“…Postoperative gastrointestinal complications after urinary diversion, such as paralytic ileus and adhesive intestinal obstruction, have been reported to occur frequently, with approximately a 30% chance of occurrence . However, small bowel obstruction due to an internal hernia caused by the ureter is an extremely rare occurrence: only four cases have been reported worldwide .…”

Section: Introductionmentioning

confidence: 99%

Small bowel obstruction due to internal hernia caused by the ureter after laparoscopic radical cystectomy and ileal conduit: A case report

Ataka

Sato

Matsubara

et al. 2018

Asian J Endoscop Surgery

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A 74-year-old man presented at our hospital with complaints of abdominal pain, nausea, and vomiting. He had undergone laparoscopic radical cystectomy and ileal conduit for urinary bladder cancer 1 month earlier. The patient had abdominal distention, resonant sounds on percussion, and diffuse abdominal tenderness without rebound or guarding. Abdominal CT revealed dilated jejunal loops herniated through a cord-like structure. Based on these findings, emergency surgery was performed, and intestinal dilatation into the space between the ureter, the ileal conduit, and the sacral bone was detected. The loops were released manually and were not resected. To the best of our knowledge, this is the first case report of small bowel obstruction due to internal hernia caused by the ureter after laparoscopic radical cystectomy and ileal conduit. Retroperitonealization and the minimum required mobilization of the ureters may be necessary when urinary diversion is constructed, especially in laparoscopic or robotic surgeries.

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Successful wound closure using fibrin glue for intractable neobladder‐urethral anastomosis leakage after radical cystectomy and neobladder reconstruction

et al. 2023

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IntroductionComplications of cystectomy and neobladder reconstruction such as anastomotic leakage have been reported. It is a common complication; however, most cases improve conservatively. The use of fibrin glue for fistulas has been reported, but no reports have shown its effectiveness for urinary tract anastomotic leakage. We experienced a case of intractable neobladder‐urethral anastomosis leakage after radical cystectomy and neobladder reconstruction, which was effectively managed using fibrin glue.Case presentationA 70‐year‐old man underwent radical cystectomy and ileal neobladder reconstruction for invasive bladder cancer with urothelial carcinoma. After surgery, the urethral catheter fell off and the anastomotic leakage did not improve by adjusting the position of the urethral catheter and percutaneous nephrostomy. We closed the intractable neobladder‐urethral anastomotic leakage by injecting fibrin glue and the leakage completely disappeared.ConclusionInjecting fibrin glue into anastomotic site can be effective in severe neobladder‐urethral anastomosis leakage.

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Surgical Complications of Urinary Diversion

Cited by 40 publications

References 80 publications

Cognitive Status and Functional Dexterity as Outcome Predictors Following Urinary Diversion: A Combined Retrospective and Prospective Observational Study

Cognitive Status and Functional Dexterity as Outcome Predictors Following Urinary Diversion: A Combined Retrospective and Prospective Observational Study

Small bowel obstruction due to internal hernia caused by the ureter after laparoscopic radical cystectomy and ileal conduit: A case report

Successful wound closure using fibrin glue for intractable neobladder‐urethral anastomosis leakage after radical cystectomy and neobladder reconstruction

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