[Experience with incontinent urinary diversion--review of 31 ureterocutaneostomies, 101 ileal conduits and 107 colonic conduits].
During the past 20 years, 31 ureterocutaneostomies (UC), 101 ileal conduits (IC) and 107 colonic conduits (CC) were performed. In the UC group, most of the patients were aged or had unresectable invasive pelvic malignancies. The operative mortality was 6.5% and acute pyelonephritis was noted frequently (48.3%). Stomal stenosis also developed significantly (63.5%). The operative mortalities in the IC group and CC group were 6.9% and 9.3%, respectively. Although the incidences of bowel obstruction, bowel fistula and renal calculi were higher in the IC group (18.8% vs 7.5% and 6.9% vs 0%, respectively). The serum creatinine level was lowest in the CC group (0.90 +/- 0.46 mg/dl) and highest in the UC group (1.36 +/- 0.75 mg/dl). Conduit ureteral reflux was frequent in the UC group (66.7%) but rare in the CC group (1.3%). We conclude that UC should be indicated in the selected patients with high risk, and IC and CC are indicated in patients who may have good prognosis but not indicated for continent reservoir or neobladder. We prefer CC in the younger group.
Department of Urology, Fujita Health University, School of Medicine.
K
K
Hoshinaga
Y
Y
Naide
I
I
Nagakubo
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery; D007668:Kidney / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D016737:Proctocolectomy, Restorative; D011379:Prognosis; D014519:Ureterostomy; D001749:Urinary Bladder Neoplasms / Q000601:surgery; D014547:Urinary Diversion / Q000379:methods*; D016476:Urinary Reservoirs, Continent