Long term complications following ileal conduit urinary diversion after radical cystectomy.

PURPOSE: To study the long term complications of ileal conduit urinary diversion in 36 patients with invasive urinary bladder cancer who lived more than 5 years after surgery. PATIENTS AND METHODS: A retrospective study included 36 long term survivors (survival 5 years or greater) with invasive bladder cancer who did radical cystectomy or anterior pelvic excentration with ileal conduit urinary diversion at the National Cancer Institute, Cairo University before January 2004.
RESULTS: A total of 36 patients, 28 Males and 8 females, with median age at surgery of 62 years. Complications developed in 22 (61%) patients and surgical re-intervention was needed, in 14 patients (39%). Stoma related complications developed in 7 (19%) patients, bowel related complications developed in 4 (11%), urinary tract infection and pyelonephritis was observed in 9 (25%) patients, conduit/ureteral anastomosis related complications developed in 5 (14%) patients, urolithiasis developed in 4 (11%) patients. Renal function deterioration (morphological and functional) was observed in 9 (25%) patients, nephrectomy was required in 2 patients, hemodialysis was required in 1 patient, and 1 patient had persistent hyperchloremic acidosis.
CONCLUSION: Long term follow-up for patients with ileal conduit urinary diversion shows high complication and high surgical re-intervention rates following this technique. Longer follow-up period for 20 or more years is needed for all urinary diversion techniques to prove either the ileal conduit will remain the gold standard for urinary diversion or other newly developed techniques will take its place. KEY WORDS: Urinary diversion - Treatment outcome - Renal function tests - Postoperative complications.