Bowel preparation versus no preparation before ileal urinary diversion.
OBJECTIVE
To compare the outcome and complications of urinary diversion using ileum, with and without bowel preparation. Recent studies have questioned the necessity of bowel preparation, especially for urinary diversion when ileum is used.


METHODS
In this clinical trial, 30 candidates for urinary diversion underwent a 3-day standard bowel preparation (group 1), and 32 were admitted 24 hours before surgery and received only a soft diet, with no oral intake, 8 hours before surgery (group 2). They were followed up for at least 6 months and were evaluated for outcome and surgical complications.


RESULTS
All surgical operations were performed successfully using ileum. Postoperative complications were documented in 2 and 4 patients in groups 1 and 2, respectively (relative risk 0.69, 95% confidence interval 0.37 to 1.31, P = 0.41). Anastomotic leak, enterocutaneous fistula, and wound infection and dehiscence occurred in 1 patient in group 1, leading to reoperation. One case of ileus was also seen in group 1. In group 2, wound infection and dehiscence occurred 2 in patients and ileus in 2 others.


CONCLUSIONS
This study failed to demonstrate any advantage of bowel preparation for urinary diversion when we use the ileal segment. Furthermore, a meticulous use of ileum can be done without the need for a colon segment in bladder substitution procedures.
Tabibi
Ali
A
Department of Urology, Shaheed Labbafinejad Medical Center, Shaheed Beheshti University of Medical Sciences, Tehran, Iran. alitabibi@unrc.ir
Simforoosh
Nasser
N
Basiri
Abbas
A
Ezzatnejad
Mohammadreza
M
Abdi
Hamidreza
H
Farrokhi
Farhat
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001726:Bisacodyl / Q000008:administration & dosage; D002368:Castor Oil / Q000008:administration & dosage; D002400:Cathartics / Q000008:administration & dosage*; D002648:Child; D004032:Diet; D004733:Enema; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011300:Preoperative Care; D014547:Urinary Diversion
D002400:Cathartics; D001726:Bisacodyl; D002368:Castor Oil