title: Rediversion after urinary diversion: a single-centre experience.
abstract: OBJECTIVE
  This study aimed to reveal the late results of rediversion after urinary diversion.
  
  
  METHODS
  From 1985 to 2009, 28 patients underwent rediversion at the Department of Urology, Lund University Hospital, Sweden. Median follow-up after rediversion was 147 months (range 7-300 months, interquartile range 63-214). The following rediversions were performed: ileal conduit, cutaneous ureterostomy, ureterosigmoidostomy and rectal bladder to continent cutaneous diversion (group I, n = 17); cutaneous ureterostomy to neobladder (group II, n = 1); ileal conduit and cutaneous ureterostomy to gastric conduit (group III, n = 2); and continent cutaneous diversion and neobladder to ileal conduit (group IV, n = 8).
  
  
  RESULTS
  In group I, reoperations were necessary after rediversion in nine of the 17 patients. Excellent functional results were obtained in 14 patients. Two patients, both with Kock pouches, underwent multiple operations and finally required rediversion to an ileal conduit. The sole patient in group II had a ureteric reimplantation owing to ureterointestinal stricture and is now continent but performs clean intermittent catheterization. Both patients in group III underwent reoperations owing to ureteric strictures and renal stones. In group IV, one patient had ureteric stenosis, and one died owing to complications related to later surgery for small bowel obstruction.
  
  
  CONCLUSIONS
  Complications are common after urinary rediversion, and several of the present patients required reoperations for a variety of reasons. Modern techniques for continent cutaneous diversion can provide excellent functional results. Patients with difficulties in accepting a urostomy bag pose special problems and need extensive information and counselling.
authors.affiliation: Department of Urology, SUS , Malmö , Sweden.
authors.forename: Fredrik
authors.initials: F
authors.lastname: Liedberg
authors.forename: Stig
authors.initials: S
authors.lastname: Colleen
authors.forename: Thomas
authors.initials: T
authors.lastname: Davidsson
authors.forename: Wiking
authors.initials: W
authors.lastname: Månsson
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D014547:Urinary Diversion / Q000379:methods*; D055815:Young Adult