Eighteen women with incurable stress incontinence underwent ileal loop urinary diversion. Eight patients required surgical revision of their stomas. Another eight patients required the formation of iatrogenic vesicovaginal fistulas but subsequently underwent cystectomy for persistent vesical discharge. Twelve patients with a psychiatric history underwent a total of 29 further operations after diversion compared with a total of six operations for the six patients without a psychiatric history. Urinary diversion is an unsatisfactory solution to the problem of incurable stress incontinence and the relationship between psychiatric disorders and incurable stress incontinence requires further study.
Read full abstract