Routine pouchograms are not necessary after continent urinary diversion.
OBJECTIVE
Pouchograms are routinely performed before catheter removal after continent urinary diversion at our institution. Our aim was to determine the necessity of pouchograms based on a review of our experience.


METHODS
A retrospective review of patient records and radiographic studies was done for patients undergoing radical cystectomy and continent urinary diversions between 1991 and 2001.


RESULTS
Seventy-two patients underwent continent urinary diversion (orthotopic, n = 59; cutaneous, n = 13) during the study period. All underwent pouchogram postoperatively (median 22 days; range 20 to 27). Six patients (8.3%) had a demonstrable radiographic leak; in 5 of the 6 patients, the urine leak was suspected on clinical grounds. Three patients (4.7%) developed urosepsis after pouchogram.


CONCLUSIONS
Our findings indicate that routine pouchograms before pouch activation after continent urinary diversion may not be necessary.
Ankem
Murali K
MK
Division of Urology, Department of Surgery, University of Medicine and Dentistry of New Jersey Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
Han
Ken-Ryu
KR
Hartanto
Victor
V
Perrotti
Michael
M
Decarvalho
Victor S
VS
Cummings
Kenneth B
KB
Weiss
Robert E
RE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D002295:Carcinoma, Transitional Cell / Q000601:surgery; D002431:Cecostomy; D003106:Colon / Q000000981:diagnostic imaging / Q000601:surgery; D003199:Computer Systems; D003287:Contrast Media; D015653:Cystectomy; D020878:Device Removal; D003955:Diagnostic Tests, Routine; D005119:Extravasation of Diagnostic and Therapeutic Materials; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007082:Ileum / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods*; D012189:Retrospective Studies; D019564:Unnecessary Procedures; D001749:Urinary Bladder Neoplasms / Q000601:surgery; D014546:Urinary Catheterization; D014547:Urinary Diversion; D016476:Urinary Reservoirs, Continent
D003287:Contrast Media