1250 FLUORESCENT CYSTOSCOPY WITH HEXAMINOLEVULINATE: DIAGNOSTIC ACCURACY FOR NON MUSCLE INVASIVE BLADDER CANCER

Abstract

INTRODUCTION AND OBJECTIVES: The risk estimation of secondary tumors following different kinds of urinary diversion using intestinal segments has only been possible for ureterosigmoidostomies yet due to the lack of follow-up studies. METHODS: We analyzed the operation records of 44 German clinics for all kinds of urinary diversion operated from 1970–2007 and registerated all reported secondary tumors of these clinics up to 2009. RESULTS: In 17.758 urinary diversions 32 secondary tumors occurred. The tumor risk in ureterosigmoidostomies (2,58%) and cystoplasties (1,58%) is significantly higher than in other continent forms of urinary diversion (p 0,0001). The tumor risk in orthotopic (ileo-) colonic neobladders (0,97%) is significantly (p 0,0001) higher than in ileal neobladders (0,05%). The difference between ileocoecal pouches (0,18%) versus ileal neobladders is not significant (p 0,46). The tumor risk following ileal conduits is minimal (0,02%). CONCLUSIONS: Ureterosigmoidostomies, cystoplasties and probably orthotopic (ileo-)colonic neobladders bear a significantly increased tumor risk compared to the general population with necessity of regular endoscopic controls at least from the 5th postoperative year on. Following ileal neobladders, conduits and probably catheterizable ileocoecal pouches regular endoscopic controls are not necessary.