MP49-05 STOMA COMPLICATIONS AND QUALITY OF LIFE IN INDIANA POUCH URINARY DIVERSION

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Ureter (including Pyeloplasty) and Bladder Reconstruction (including fistula), Augmentation, Substitution, Diversion I1 Apr 2018MP49-05 STOMA COMPLICATIONS AND QUALITY OF LIFE IN INDIANA POUCH URINARY DIVERSION Kai Wen Cheng, Ankeet Shah, Gus Miranda, Anne Schuckman, and Hooman Djaladat Kai Wen ChengKai Wen Cheng More articles by this author , Ankeet ShahAnkeet Shah More articles by this author , Gus MirandaGus Miranda More articles by this author , Anne SchuckmanAnne Schuckman More articles by this author , and Hooman DjaladatHooman Djaladat More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1596AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The Indiana Pouch (IP) is a subtype of Continent Cutaneous Urinary Diversion (CCUD) for which quality of life and CCUD-specific complications have not been well studied. We sought to evaluate the IP diversion using the aforementioned variables. METHODS A retrospective review of an IRB-approved IP database was conducted for perioperative and outcome data. To assess quality of life, the EORTC QLQ-C30 questionnaire was mailed to patients who agreed to be contacted. All responses were dated >6 months after IP surgery. RESULTS A total of 33 patients who received the IP diversion under 2 fellowship-trained urologic oncologists were included in this study (2010-2016). Patient characteristics, diversion-specific complications, and outcome data are shown in Table 1. After a median follow up of 18 months (range: 2.7-72.8), Low-grade diversion-related Clavien complications (including related GI complications) were reported in 28 patients (85%), but high-grade in 8 patients (24%). Stoma complications were seen in 10 patients (30%), 5 low-grade and 5 high-grade; 7 had stenosis at skin/fascia level that needed outpatient dilation or superficial revision and 3 needed deeper level revision for difficult catheterization. Median time to stoma revision was 12 months (range: 5-22). A higher BMI (29 vs. 26) was associated with stoma complication (p =0.01), but stoma size, measured as size of catheter used to taper the ileal segment, was not (p=0.4). All patients achieved continence within 90 days after surgery; coaptite injection was indicated for 1 patient. 14 responses were recorded for the EORTC questionnaire: >70% of patients reported little to no disturbance of daily functions and rated overall health and quality of life as ≥70% (Table 2). CONCLUSIONS The Indiana Pouch diversion is associated with high rates of continence and patient satisfaction. Stoma complication is common; however, most of them are superficial and managed with outpatient/minor procedures. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e667-e668 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Kai Wen Cheng More articles by this author Ankeet Shah More articles by this author Gus Miranda More articles by this author Anne Schuckman More articles by this author Hooman Djaladat More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...