1164 CUTANEOUS URETEROSTOMY BACK TO THE FUTURE?

Abstract

You have accessJournal of UrologyUrinary Diversion: Bladder Reconstruction, Augmentation, Substitution, Diversion1 Apr 20121164 CUTANEOUS URETEROSTOMY BACK TO THE FUTURE? Arnaud Doerfler, Charles Chahwan, Sophie Le Gal, Sophie LE Toquin-Bernard, and Henri Bensadoun Arnaud DoerflerArnaud Doerfler Caen, France More articles by this author , Charles ChahwanCharles Chahwan Caen, France More articles by this author , Sophie Le GalSophie Le Gal Caen, France More articles by this author , Sophie LE Toquin-BernardSophie LE Toquin-Bernard Caen, France More articles by this author , and Henri BensadounHenri Bensadoun Caen, France More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1388AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The cystectomy triggers a urinary derivation problem. Ileal conduit or bladder replacement are usually considered. These derivations, even realized among patients in good condition, show a high complication's rate. The cutaneous ureterostomy (CU) seemed to be an interesting alternative. The goal of this study is to evaluate the morbi-mortality linked to CU in our department and patient's quality of life. METHODS We retrospectively studied all the cystectomies with CU performed between 2008 and 2011. The following parameters were extracted: surgery indication, operative time, per and post-operative complications, early and late complications, digestive transit recovery, hospital stay duration, mortality and quality of life. RESULTS Fifty one CU were performed, among 40 males (78.4%) and 11 females (21.6%). Mean age was 73.7 [54-92] years. Mean follow-up was 13 [2-28] months. Cystectomy was performed for tumor (70%), radiation cystitis (15%) and others (15%). Mean operative time was 119 [92-153] min. CU was unilateral with a gun barrel shape in 50%, bilateral in 30% and single in 20%. Early morbidity was digestive complications (ileus, fistula, evisceration) in 7 cases (13 %) requiring 2 surgical reinterventions, as well as medical complications (infections, phlebitis) in 20 % of the patients. Mean hospital stay was of 11.4 [7-26] days. The post-operative mortality rate was 3.9 %. Late morbidity (stent issue, pyelonephritis) was related to 15.4%.The quality of life, estimated by the Stoma-QOL scale, was considered to be very satisfactory by patients who were happy with urinary derivation. CONCLUSIONS The CU is a simple intervention, reproducible, with a reasonable mortality. The early morbidity and the duration of hospitalization are reduced by the absence of intestinal use. The CU is well accepted by the patients who consider as satisfying their quality of life. This “old fashion” procedure should be rehabilitated because of the higher and higher frequency of radical cystectomy in the elderly and high risk patients. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e472 Peer Review Report Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Arnaud Doerfler Caen, France More articles by this author Charles Chahwan Caen, France More articles by this author Sophie Le Gal Caen, France More articles by this author Sophie LE Toquin-Bernard Caen, France More articles by this author Henri Bensadoun Caen, France More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...