MP60-15 PATTERNS OF URINARY DIVERSION AFTER RADICAL CYSTECTOMY OVER THE PAST 20 YEARS: A POPULATION-BASED ANALYSIS

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive III1 Apr 2014MP60-15 PATTERNS OF URINARY DIVERSION AFTER RADICAL CYSTECTOMY OVER THE PAST 20 YEARS: A POPULATION-BASED ANALYSIS Dustin Hyatt, Oluwakayode Adejoro, Sean Elliott, and Joel Slaton Dustin HyattDustin Hyatt More articles by this author , Oluwakayode AdejoroOluwakayode Adejoro More articles by this author , Sean ElliottSean Elliott More articles by this author , and Joel SlatonJoel Slaton More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1769AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Over the past twenty years, there has been a large push within the urological community towards the greater use of catheterizable urinary pouches and neobladders when compared to ileal conduits. We performed a population-based analysis to determine current patterns of use and factors associated with choice of specific urinary diversions. Methods We interrogated the SEER-Medicare Database from the years 1992-2009 to identify all patients undergoing radical cystectomy for urothelial cancer and for specific choice of urinary diversion used. Parameters including age, race, gender, income, education, and stage of cancer were correlated with choice of urinary diversion. Results Among the 5892 cystectomy and urinary diversions that were performed, Continent urinary diversion (CUD) vs ileal diversions were performed in 14% in 1992. This percentage rose to 23-25% for the rest of the 1990’s but has gradually fallen off to 16-18% in the 2000’s. Receiving a CUD had a significant effect (Tis, Ta, T1 – 27%; T2 -21%; 19%) As might be expected the percentage of patients undergo a CUD decreased with age (65-69, 29%; 70-74, 22%; 75-79, 14%; and >80, 9%). With respect to gender, 21% of men had a CUD and 14% of women with the number in the latter group rising over the past 20 years. Race played a minimal part in decision making (Caucasian 18% vs nonwhite 22%). Regionally, the West perform 50% higher number of CD. The patients with the highest income (22% vs 13%), higher education (26% vs 17%) and lower Charlson score (0 vs 1, 21% vs 15%)had a higher change of obtaining a CUD. Conclusions Despite a large push among the urologic community over the past two decades, continent diversions appear to have peaked in the 1990’s and modestly fell off into the 2000’s. Patients receiving CUD were more likely to be male, young, better education, and higher income. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e638 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Dustin Hyatt More articles by this author Oluwakayode Adejoro More articles by this author Sean Elliott More articles by this author Joel Slaton More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...