Long-term outcome of ileal conduit diversion.
OBJECTIVE
Ileal conduit is considered a safe procedure and the gold standard to which newer forms of urinary diversion should be compared, although few long-term results are known. We analyzed a consecutive series of patients who lived a minimum of 5 years after ileal conduit diversion.


METHODS
A total of 412 patients underwent ileal conduit diversion between 1971 and 1995 at our institution. We analyzed all conduit related complications occurring later than 3 months after surgery in 131 long-term survivors (survival 5 years or greater).


RESULTS
Median followup was 98 months (range 60 to 354). Overall 192 conduit related complications developed in 87 of 131 (66%) patients. The most frequent complications were related to kidney function/morphology in 35 patients (27%), stoma in 32 (24%), bowel in 32 (24%), symptomatic urinary tract infection (including pyelonephritis) in 30 (23%), conduit/ureteral anastomosis in 18 (14%) and urolithiasis in 12 (9%). Within the first 5 years complications developed in 45% of patients. This percentage increased to 50%, 54% and 94% in those surviving 10, 15 and longer than 15 years, respectively. In this last group 50% had upper urinary tract changes and 38% had urolithiasis, for which the respective numbers after 5 years were 12% and 17%.


CONCLUSIONS
This study demonstrates a high conduit related complication rate in long-term survivors and underlines the need for vigorous long-term followup. Only studies lasting more than 1 decade cover the entire morbidity spectrum.
Madersbacher
Stephen
S
Department of Urology, University of Bern, Switzerland.
Schmidt
Jochen
J
Eberle
Johannes M
JM
Thoeny
Harriet C
HC
Burkhard
Fiona
F
Hochreiter
Werner
W
Studer
Urs E
UE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000601:surgery; D007410:Intestinal Diseases / Q000209:etiology; D007668:Kidney / Q000503:physiopathology; D008875:Middle Aged; D010030:Ostomy / Q000009:adverse effects; D016896:Treatment Outcome; D014545:Urinary Calculi / Q000209:etiology; D014547:Urinary Diversion / Q000009:adverse effects* / Q000379:methods; D014552:Urinary Tract Infections / Q000209:etiology