Diagnosis and treatment of a urinary leak after ureteroileal conduit for diversion.

Of 1,120 cases of ileal loop urinary diversion reviewed from our hospital 21 postoperative loop leaks were noted (1.87 per cent). Definite indications for diagnostic studies of urinary extravasation include persistent postoperative azotemia, sepsis and/or urinary leakage via the drains. In this series 2 types of loop leaks were noted--an early postoperative leak within the first 24 hours and a leakage 6 to 12 days postoperatively. More aggressive management of postoperatively urinary extravasation is urged, especially in patients who had been irradiated and suffered leakage later on in the postoperative course.