title: Fate of the leftover bladder after supravesical urinary diversion for benign disease.
abstract: OBJECTIVE
  We studied the fate of the leftover bladder in patients who underwent supravesical urinary diversion without cystectomy for benign pathology.
  
  
  METHODS
  This retrospective study was performed in 9 males and 15 females with a median age of 59 years in whom supravesical urinary diversion was performed for various benign conditions from 1996 to 2004. These conditions were incontinence, acontractile bladder, radiation and/or hemorrhagic cystitis, and neuropathic bladder. Median followup was 48 months.
  
  
  RESULTS
  Of the patients 13 (54%) experienced problems with the retained bladder, 2 (8%) presented with urethral bleeding, which resolved by conservative means, and 11 (46%) had infective complications, which resolved with expectant treatment in 3 (12%). However, 8 patients (33%) had frank pyocystis and 3 (12%) were treated with the Spence procedure, which alleviated symptoms in only 1. Six patients (25%) required cystectomy.
  
  
  CONCLUSIONS
  In patients undergoing supravesical urinary diversion for benign disease in whom the bladder remains in situ the risks of complications related to the defunctionalized bladder are more than 50% and 25% of patients subsequently need cystectomy. These patients should be offered primary cystectomy at urinary diversion.
authors.affiliation: Department of Urology, Medway Maritime Hospital, Gillingham, Kent, UK. tajfazili@hotmail.com
authors.forename: Tajammul
authors.initials: T
authors.lastname: Fazili
authors.forename: Tahir R
authors.initials: TR
authors.lastname: Bhat
authors.forename: Shikohe
authors.initials: S
authors.lastname: Masood
authors.forename: John H
authors.initials: JH
authors.lastname: Palmer
authors.forename: G R
authors.initials: GR
authors.lastname: Mufti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D001743:Urinary Bladder / Q000601:surgery*; D001745:Urinary Bladder Diseases / Q000601:surgery*; D014547:Urinary Diversion / Q000009:adverse effects* / Q000379:methods*