A Clinical Study on Urinary Diversion Following Total Cystectomy

Kim, Hyung Jin; Park, Young Kyung

Abstract

A clinical study was made on urinary diversion following 28 cases of total cystectomy who had been admitted to the Department of Urology, Chonbuk National University, Medical School from March 1980 to June 1986. The results were as follows : 1. The age and sex distribution were from 27 to 70 years, most common in fifth decade and 23 cases were male, 5 cases were female. 2. The underlying diseases for total cystectomy were bladder tumor in 21 cases, prostatic tumor in 2 cases, urethral tumor in 1, left lower ureter and bladder tumor in 2, multiple bladder, left lower ureter and banal pelvis tumor in 1 and vesico-vagino-rectal fistula with myoma uteri in 1 case. 3. The types of urinary diversion were cutaneous ureterostomy in 1 case, ileal conduit in 9, sigmoid conduit in 2, ileocecal conduit in 4, Kock continent ileal reservoir in 1, modified Kock continent ileal reservoir in 7, ureterosigmoidostomy in 4 cases. 4. In renal function, 75 percent of cases were maintained or improved postoperatively. In excretory urographic findings, 71 percent of cases were maintained and 29 percent of cases were deteriorated postoperatively. 5. Early complications were wound infection in 2 cases, wound dehiscence in 2, paralytic ileus in 1, mechanical ileus in 1, enterocutaneous fistula in 1 and leak at ureteroileal anastomosis in 1 cases. 6. Late complications were leak at ureteroileal anastomosis in 1 case and stomal herniation in 1 case.