Does the position of the patient affect the presence and/or degree of reflux in an ileal conduit urinary diversion?
OBJECTIVE
To assess the effect of patient position (supine, sitting or standing) on ileo-ureteric reflux in patients with an ileal conduit urinary diversion, in whom such reflux is normally detected when they are supine during a retrograde loopogram.


METHODS
The study included 10 patients with an ileal conduit as a primary urinary diversion; a loopogram was obtained with the patient upright or supine and a further film taken with the patient supine but at 45 degrees to the ground.


RESULTS
When supine, free ileo-ureteric reflux occurred into both ureterorenal units in eight patients. The remaining two patients, who had previously undergone unilateral nephrectomy, also had reflux into their existing renal units. Of the 18 units, 15 had grade III and three had grade IV reflux. In the upright and 45 degrees position, reflux still occurred in al ureterorenal units. The patient's position did not affect the degree of reflux in 16 units, but in one unit with grade IV reflux and another with grade III reflux, the reflux was one grade less severe.


CONCLUSIONS
Ileo-ureteric reflux is common after ileal conduit diversion and may contribute to the likelihood of renal deterioration. The presence and/or degree of reflux is generally not affected by the position of the patient.
Baltaci
S
S
Department of Urology, University of Ankara School of Medicine, Turkey. sbaltaci@hotmail.com
Bozlu
M
M
Kosucu
P
P
Bedük
Y
Y
Gögüs
O
O
D000328:Adult; D000368:Aged; D015653:Cystectomy / Q000379:methods; D005260:Female; D006801:Humans; D007082:Ileum / Q000637:transplantation; D008297:Male; D008875:Middle Aged; D011187:Posture; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D014547:Urinary Diversion / Q000009:adverse effects*; D014718:Vesico-Ureteral Reflux / Q000209:etiology*