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Complications of cystectomy and urinary diversion


Authors: P. T. Nieh
Published in: Urol List 2008; 6(2): 48-52

Overview

Cystectomy and urinary diversion is an extensive operative procedure. The different types of urinary reconstruction are reviewed. Early postoperative complications include ileus, urinary leak, mucus obstruction, and DVT. Later problems include incontinence, difficult catheterization, stomal problems, metabolic disturbances, urinary infections, pouch stones, and hydronephrosis. Contributing factors to these problems are discussed, and appropriate management is detailed.

Key words:
cystectomy, urinary diversion, continent reservoir, neobladder, ileus, leak, mucus, incontinence, stoma, calculi, hydronephrosis


Sources

1. Bricker EM. Symposiums on clinical surgery: Bladder substitution after pelvic evisceration. Surg Clin North Am 1950; 30: 1151–1521.

2. McDougal WS. Metabolic complications of urinary intestinal diversion. J Urol 1992; 147: 1199–1208.

3. Nieh PT. The Kock pouch urinary reservoir. Urol Clin North Am 1997; 24: 755–772.

4. Stein JP, Cai J, Groshen S, Skinner DG. Risk factors for patients with pelvic lymph node metastases following radical cystectomy with en bloc pelvic lymphadenectomy: concept of lymph node density. J Urol 2003; 170(1): 35–41.

Labels
Paediatric urologist Urology
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