Morbidity following Ileal Conduit Urinary Diversion in a Welsh District Hospital over 10 years

Abstract

Objective: To assess the post-operative morbidity after ileal conduit diversion at our institution.
Patients and Methods: The records of 84 patients with a mean age of 62.1 (range 22 -89) years who underwent ileal conduit diversion at our institution between 1992 and 2002 were reviewed and all post-operative complications occurring later than 3 months after the intervention were analyzed.
Results: Overall, 242 ileal conduit-related complications (71 major and 171 minor) developed in 72 of 84 patients (85.7%). The mean and median follow-up were 38.6 and 24 months, respectively (range 3 to 108 months). A total of 38 surgical procedures / interventions were needed in 33 patients (39.3%). 62/72 patients (86.1%) developed complications within the fi rst 5 years. 32 stoma-related complications were recorded in 22/84 (26.2%) patients. Fifty-nine percent (n=42) of the major complications occurred in the 30 patients who had been subjected to diversion for non-malignant indications and had a longer mean follow-up (4.5 years) than the 54 patients who had been operated for malignancy (mean follow-up 2.5 years).
Conclusion: Patients with benign disease fared better in survival as expected, but the longer they survived, the higher was the incidence of complications and the re-intervention rate. In view of the high complication rate, especially in patients with a long life expectancy and benign conditions, objective guidelines regarding the choice of urinary diversion will help surgeons in decision making, patient selection and counseling.


Keywords: Ileal conduit diversion, complications, urinary diversion, morbidity, adult, cancer

African Journal Of Urology Vol.14 (3) 2007: pp. 147-154