Neurogenic bladder and continent cystostomy: Results of a monocentric cohort in a French university hospital

Abstract

The main objective was to evaluate the complications of continuous urinary shunts in a French university hospital according to surgical technique and functional results especially on continence. The secondary objective was to evaluate the management of complications. A retrospective study was conducted between January 2008 and August 2017. Patients who had a continent cystostomy with or without bladder augmentation were included. Diversions for non-neurological causes were excluded. Cystostomy was performed using the appendix or a Monti's artifice. Data collected included complications and their management, functionality of the diversion and of the bladder reservoir, cystostomy continence, and urethral continence. Nineteen patients were included. The median follow-up time was 46 months. The majority of early postoperative complications were classified as grade II Clavien-Dindo. No postoperative deaths occurred. Late complications most frequently involved cystostomy duct stenosis (n=5), cystostomy incontinence (n=5), and urethral incontinence (n=8). Thirteen patients had revision surgery for late complications. Late complications on continence evolved favorably after revision surgery or medical treatment in all, but one case. Our results are consistent with the literature. Complications and the re-interventions are frequent and should lead to a multidisciplinary information and evaluation of the patient in preoperative care. 3.