PD35-05 INCIDENCE, RISK FACTORS, AND NATURAL HISTORY OF PARASTOMAL HERNIA FOLLOWING RADICAL CYSTECTOMY AND ILEAL CONDUIT URINARY DIVERSION

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Ureter (including Pyeloplasty) and Bladder Reconstruction (including fistula), Augmentation, Substitution, Diversion I (PD35)1 Sep 2021PD35-05 INCIDENCE, RISK FACTORS, AND NATURAL HISTORY OF PARASTOMAL HERNIA FOLLOWING RADICAL CYSTECTOMY AND ILEAL CONDUIT URINARY DIVERSION Alireza Ghoreifi, Evan Allgood, Gilbert Whang, Wenhao Yu, Jie Cai, Gus Miranda, Monish Aron, Anne Schuckman, Mihir Desai, Inderbir Gill, Siamak Daneshmand, Vinay Duddalwar, and Hooman Djaladat Alireza GhoreifiAlireza Ghoreifi More articles by this author , Evan AllgoodEvan Allgood More articles by this author , Gilbert WhangGilbert Whang More articles by this author , Wenhao YuWenhao Yu More articles by this author , Jie CaiJie Cai More articles by this author , Gus MirandaGus Miranda More articles by this author , Monish AronMonish Aron More articles by this author , Anne SchuckmanAnne Schuckman More articles by this author , Mihir DesaiMihir Desai More articles by this author , Inderbir GillInderbir Gill More articles by this author , Siamak DaneshmandSiamak Daneshmand More articles by this author , Vinay DuddalwarVinay Duddalwar More articles by this author , and Hooman DjaladatHooman Djaladat More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002039.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Parastomal hernia (PSH) is a well-known, long-term complication of radical cystectomy (RC) and ileal conduit (IC). The aim of this study is to investigate the incidence, risk factors, and natural history of PSH over time. METHODS: Using our IRB-approved prospective database, we reviewed the records of patients who underwent RC and IC from January 2007 to January 2020. Patients who had available follow-up CT imaging were included in this study. All imagings were re-reviewed by expert radiologists for detection of PSH per Moreno-Matias classification. Patients who developed PSH were followed up and classified into stable or progressive (defined as radiologic upgrading and/or need for surgical intervention). Multivariable cox regression was performed to identify independent predictors of PSH development and progression. RESULTS: A total of 361 patients with a mean±SD age of 74.7±9 years were included in this study. The incidence of radiologic PSH was 30%, graded as I (56.5%), II (12%), and III (31.5%). Median (IQR) time to radiologic PSH was 8.3 (4.6-15) months. During the median (IQR) follow up of 27 (12.5-46.6) months in 108 patients with PSH, 26% progressed and 15% required surgical intervention. Median (IQR) time to progression was 11.7 (5.5-20.7) months (Figure-1). On multivariable analysis, female gender (HR 1.86), diabetes (HR 1.81), chronic obstructive pulmonary disease (HR 1.78), and higher body mass index (HR 1.07 per unit increase) were independent predictors for radiologic PSH development (Table-1). No significant factor was found to be associated with PSH progression. Surgical interventions were significantly higher in patients with grade III radiologic PSH (HR 4, 95%CI 1.4-11.5). CONCLUSIONS: The incidence of PSH following radical cystectomy is 30%, with a quarter of patients progressing during follow-up. Female gender, diabetes, chronic obstructive pulmonary disease, and high body mass index are independent predictors for radiologic PSH development. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e589-e590 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alireza Ghoreifi More articles by this author Evan Allgood More articles by this author Gilbert Whang More articles by this author Wenhao Yu More articles by this author Jie Cai More articles by this author Gus Miranda More articles by this author Monish Aron More articles by this author Anne Schuckman More articles by this author Mihir Desai More articles by this author Inderbir Gill More articles by this author Siamak Daneshmand More articles by this author Vinay Duddalwar More articles by this author Hooman Djaladat More articles by this author Expand All Advertisement Loading ...