title: Parastomal hernia after ileal conduit with a prophylactic mesh: a 10 year consecutive case series.
abstract: OBJECTIVE
  There are no data on the frequency of parastomal hernia (PSH) after ileal conduit with a prophylactic mesh. The primary objective of this study was to determine the prevalence of PSH. Secondary objectives were to elaborate whether age, gender, body mass index (BMI), previous laparotomy or diabetes influenced the outcome; and to find any mesh-related complications.
  
  
  METHODS
  In a single centre during 2003-2012, a large-pore, lightweight mesh was placed in a sublay position in 114 consecutive patients with ileal conduits. Preoperative and postoperative patient data were retrospectively collected and cross-sectional follow-up was conducted. During the predefined clinical examination a PSH was defined as any protrusion in the vicinity of the ostomy with the patient straining in both an erect and a supine position.
  
  
  RESULTS
  Fifty-eight patients (24 women and 34 men, mean age 69 years) had follow-up examinations after a mean of 35 months (median 32 months). Bladder cancer was the most common cause for surgery. Eight patients (14%) had a PSH. Age, gender, BMI, previous laparotomy and diabetes did not affect the outcome. No mesh-related complications occurred among the 114 patients with a prophylactic mesh.
  
  
  CONCLUSIONS
  The prevalence of PSH after ileal conduit with a prophylactic mesh corresponded to that of colostomies with a prophylactic mesh. A prophylactic mesh did not seem to be associated with complications. The degree to which a prophylactic mesh may reduce the rate of PSH after an ileal conduit should be established in randomized trials.
authors: Department of Urology, Sundsvall Hospital , Sundsvall , Sweden.
authors: Johan
authors: J
authors: Styrke
authors: Markus
authors: M
authors: Johansson
authors: Gabriel
authors: G
authors: Granåsen
authors: Leif
authors: L
authors: Israelsson
mesh_terms: D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D002295:Carcinoma, Transitional Cell / Q000601:surgery*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D015653:Cystectomy; D018856:Cystitis, Interstitial / Q000601:surgery*; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000069290:Incisional Hernia / Q000453:epidemiology* / Q000517:prevention & control; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D011832:Radiation Injuries / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013526:Surgical Mesh; D054047:Surgical Stomas; D013548:Sweden / Q000453:epidemiology; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D001750:Urinary Bladder, Neurogenic / Q000601:surgery*; D014547:Urinary Diversion
keywords: bladder cancer; ostomy; parastomal hernia; surgical mesh; urinary diversion