Patient Selection, Operative Technique, and Contemporary Outcomes of Continent Catheterizable Diversion: the Indiana Pouch

Abstract

Techniques for continent cutaneous urinary diversion (CCD) have evolved considerably over the last 65 years. The Indiana pouch (IP) was initially described in the 1980s and has gained wide acceptance among urologists. For patients who desire continent urinary diversion, many clinical scenarios and individual preferences continue to make the IP an excellent option for appropriately selected patients. Continence rates for the IP are generally satisfactory and compare favorably with orthotopic neobladder. Unfortunately, radical cystectomy with urinary diversion is associated with a high complication rate. We discuss short-term (<90 days) and long-term complications for CCD with attention to specific complications related to the efferent limb and continent pouch. Finally, we discuss health-related quality of life (HRQOL) after IP urinary diversion with comparison to the orthotopic neobladder and conduit diversion.