PD11-03 FOLLOW-UP SURGICAL INTERVENTIONS IN PATIENTS WITH URINARY DIVERSION: A COMPARISON BETWEEN ORTHOTOPIC NEOBLADDERS AND ILEAL CONDUITS

Abstract

You have accessJournal of UrologyUrinary Diversion: Bladder Reconstruction, Augmentation, Substitution, Diversion II1 Apr 2015PD11-03 FOLLOW-UP SURGICAL INTERVENTIONS IN PATIENTS WITH URINARY DIVERSION: A COMPARISON BETWEEN ORTHOTOPIC NEOBLADDERS AND ILEAL CONDUITS David Flores, Katie Murray, William Parker, Daniel Zainfeld, Moben Mirza, and Jeffrey Holzbeierlein David FloresDavid Flores More articles by this author , Katie MurrayKatie Murray More articles by this author , William ParkerWilliam Parker More articles by this author , Daniel ZainfeldDaniel Zainfeld More articles by this author , Moben MirzaMoben Mirza More articles by this author , and Jeffrey HolzbeierleinJeffrey Holzbeierlein More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1092AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Patients undergoing radical cystectomy with urinary diversion often require additional surgical interventions related to their urinary diversion. The objective of this study was to compare the type of urinary diversion performed with the type of surgical interventions that patients underwent related to their cystectomy and urinary diversion to assess if the type of urinary diversion increased the likelihood of requiring follow-up surgical procedures. METHODS This was a retrospective review of patients undergoing a radial cystectomy with either a neobladder or ileal conduit reconstruction at the University of Kansas from 2004 until 2013. Specific data regarding the need for additional surgical procedures performed at the University of Kansas were recorded. Procedures included were any urological stone procedure, reconstructive procedures including artificial urinary sphincter (AUS) and inflatable penile prosthesis (IPP), open procedures of the abdomen including ureteral anastomosis revisions as well as incisional/ventral hernia repairs, and endoscopic procedures of the urethra, neobladder, ileal conduit or ureters. RESULTS In reviewing 240 patients, 120 in each arm, we found that neobladder patients were more than three times more likely to require an endoscopic intervention (OR 3.9) and were more than twice as likely to require additional open surgical interventions (OR 2.8) when compared to patients that underwent the creation of a ileal conduit. The number of ventral hernias was higher in the neobladder group, but did not reach statistical significance with 17 in the neobladder group and 10 in the ileal conduit group. The number of patients that underwent an intervention for a ureteral enteric (U-E) stricture was similar between the two groups, but the ileal conduit patients underwent more total number of interventions for U-E strictures (54 vs. 35). CONCLUSIONS Many patients undergoing a radial cystectomy will require additional surgical procedures throughout the remainder of their life and this is important to consider when counseling patients about the choice of urinary diversion. It is generally accepted that comparing patients with IC and NB is not comparing apples to apples, as demonstrated in the difference in Age and sex of the two cohorts, but this study document that patients undergoing the creation of an orthotopic neobladder are much more likely to undergo additional surgical procedures which may be an important factor in counseling this population with many medical comorbidities. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e251-e252 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information David Flores More articles by this author Katie Murray More articles by this author William Parker More articles by this author Daniel Zainfeld More articles by this author Moben Mirza More articles by this author Jeffrey Holzbeierlein More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...