[Should one perform supravesical urinary diversions with excluded bladder in patients with cancer?].
OBJECTIVE
To review our experience in 37 patients who had undergone supravesical urinary diversion with defunctionalized bladder left in situ.


METHODS
The pathological conditions that indicated surgery were advanced infiltrating bladder carcinoma and bladder irradiation due to other pelvic organ malignancies.


RESULTS
The analysis showed 70.25% of the patients had complications, the most common being hemorrhage (27.07%), followed by pyocyst (13.51%). Four patients (10.81%) required rehospitalization for treatment of complications. The patients were treated with a combination of parenteral antibiotics and continuous bladder irrigations using a variety of antiseptic solutions. One patient required a permanent cystostomy.


CONCLUSIONS
There is a need to evaluate the benefit of the supravesical urinary diversion with defunctionalized bladder left in situ in patients with advanced infiltrating bladder carcinoma and bladder irradiation due to other pelvic organ malignancies. The type of diversion is unrelated to the complications that develop in the defunctionalized bladder. Patients with positive urine cultures and/or urethral stricture preoperatively have an increased risk of developing pyocyst.
Granados
E A
EA
Unidad Uro-oncología, Fundación Puigvert, Barcelona, España.
Salvador
J
J
Villavicencio
H
H
Vicente
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017577:Cutaneous Fistula / Q000209:etiology; D003556:Cystitis / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010146:Pain / Q000209:etiology; D010386:Pelvic Neoplasms / Q000532:radiotherapy; D011183:Postoperative Complications / Q000209:etiology*; D011832:Radiation Injuries / Q000209:etiology / Q000601:surgery*; D011867:Radioisotope Teletherapy / Q000009:adverse effects; D012189:Retrospective Studies; D014525:Urethral Stricture / Q000150:complications; D001743:Urinary Bladder / Q000293:injuries / Q000473:pathology / Q000601:surgery; D001745:Urinary Bladder Diseases / Q000209:etiology / Q000601:surgery*; D001747:Urinary Bladder Fistula / Q000209:etiology; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery*; D014547:Urinary Diversion / Q000009:adverse effects / Q000379:methods*; D014552:Urinary Tract Infections / Q000150:complications