Fate of tetraplegic patients managed by ileal conduit for urinary control: long-term follow-up.
BACKGROUND
A study was conducted to evaluate our experience of ileal-conduit formation in tetraplegic patients with special reference to late complications due to upper urinary tract stones and pyocystis.


METHODS
Ileal-conduit formation was performed in 16 patients with tetraplegia to improve urinary management. The mean age at operation was 46 years (range 19-70) and the mean follow-up period was 8.7 years (range 2-17). We evaluated the results retrospectively from patients' medical records.


RESULTS
Two patients died 2 years after the procedure and one patient died 8 years after the ileal-conduit formation. Five patients suffered from repeated renal or ureteral stone. In three of these cases, serious urinary tract infections developed whenever the stone caused an obstruction. Three patients received a cystectomy at the time of the ileal-conduit formation. Eight patients suffered from empyema of the bladder and in two of these cases a subsequent cystectomy was required.


CONCLUSIONS
Ileal-conduit formation should be cautiously considered as an option in the urinary management of tetraplegic patients, particularly when more conservative management strategies have proved unsuccessful. However, an antirefluxing mechanism for the ileal conduit may be necessary, and a simultaneous cystectomy may improve the results.
Kato
Haruaki
H
Department of Urology, Shinshu University School of Medicine, Matsumoto, Japan. kart@hsp.md.shinshu-u.ac.jp
Hosaka
Kyoko
K
Kobayashi
Shinya
S
Igawa
Yasuhiko
Y
Nishizawa
Osamu
O
D000328:Adult; D000368:Aged; D020211:Autonomic Dysreflexia / Q000209:etiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011782:Quadriplegia / Q000150:complications*; D012189:Retrospective Studies; D014545:Urinary Calculi / Q000209:etiology; D014547:Urinary Diversion; D014555:Urination Disorders / Q000209:etiology / Q000601:surgery