LONG-TERM OUTCOME OF INCONTINENT ILEOVESICOSTOMY MANAGEMENT OF SEVERE LOWER URINARY TRACT DYSFUNCTION

Abstract

Purpose We evaluated the extended 5-year followup outcome of incontinent ileovesicostomy. Materials and Methods We reviewed the charts of 25 men and 13 women with a mean age of 44.9 years who underwent incontinent ileovesicostomy, including the original 23 patients whom we reported on in 1993. Mean followup was 52 months. We compared the incidence of complications before and after ileovesicostomy as well as long-term urinary tract status. Results Before ileovesicostomy the incidence of serious complications associated with an indwelling catheter was significant, including poor bladder compliance in 50% of cases, urosepsis in 45%, hydronephrosis in 21%, renal struvite calculi in 18%, urethrocutaneous fistula in 18%, autonomic dysreflexia in 13% and bladder calculi in 2%. After conversion to ileovesicostomy our data show that 83 to 91% of this high risk population maintained a normal upper urinary tract and normal bladder storage compliance. Conclusions Compared with preoperative status the incidence of postoperative complications was relatively low and they were readily corrected. Ileovesicostomy is an excellent long-term management solution for severe lower urinary tract dysfunction in patients who are unable to perform intermittent self-catheterization.