Urinary Undiversion: Indications, Technique and Results in 50 Cases

Bladder stone formation after sigmoidocolocystoplasty: statistical analysis of risk factors

“…Asymptomatic bacteriuria with mixed organisms has been reported to occur in 50% to 100% of patients with augmentation cystoplasties [14][15][16][17], which was also experienced in the present study. Blyth et al [2] and Palmer et al [3] reported that bacteriuria with urease-splitting organisms contributed significantly to BSF after augmentation cystoplasty.…”

Augmentation cystoplasty

“…Although asymptomatic bacteriuria with mixed organisms occurs in 50±100% of augmentation cystoplasties [18,32,43,46] the incidence of signi®cant UTI is reportedly lower (4±43%) [25,52,54]. In our experience, recurrent bacteriuria is found in >75% of patients and there was a 20% incidence of troublesome UTI.…”

“…Augmentation cystoplasty is reported to have a 0±2.7% mortality, with higher mortality rates reported in the earlier series and associated with additional procedures such as undiversion [32,42,43,46,49,50,98,99]. None of our 267 patients who have been followed-up for a minimum of 5 years (range 5±17) died after surgery.…”

“…The high incidence of renal deterioration in patients with urinary diversions in the long term (usually secondary to pyelonephritis or stone disease), especially when intestinal segments with freely re¯uxing enterovesical anastomoses are used [30,31], has resulted in the current trend not to divert unless absolutely necessary and to try to reverse the procedure whenever possible. Undiversion should only be attempted if renal function is adequate and continence is likely, as such surgery may carry a mortality as high as 2% and a major complication rate of up to 16% [32].…”

Long-term results of augmentation cystoplasty in spinal cord injury patients

“…8,19 ± 22 We had two male patients who previously had a sphincterotomy and became continent up to 2 years after bladder augmentation without any other surgery for augmentation of outlet resistance. For the two patients who demonstrated obvious stress incontinence leakage, one underwent an undiversion, which is known to be associated with a higher complication rate, 23 and the other presented with complex pelvic trauma (bone fractures and bladder injury) in addition to the spinal cord trauma.…”