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Rediversion after urinary diversion: A single-centre experience.

Liedberg, Fredrik LU ; Colleen, Stig LU ; Davidsson, Thomas LU and Månsson, Wiking LU (2014) In Scandinavian Journal of Urology2013-01-01+01:00 48(1). p.99-104
Abstract
Abstract Objective. This study aimed to reveal the late results of rediversion after urinary diversion. Material and methods. From 1985 to 2009, 28 patients underwent rediversion at the Department of Urology, Lund University Hospital, Sweden. Median follow-up after rediversion was 147 months (range 7-300 months, interquartile range 63-214). The following rediversions were performed: ileal conduit, cutaneous ureterostomy, ureterosigmoidostomy and rectal bladder to continent cutaneous diversion (group I, n = 17); cutaneous ureterostomy to neobladder (group II, n = 1); ileal conduit and cutaneous ureterostomy to gastric conduit (group III, n = 2); and continent cutaneous diversion and neobladder to ileal conduit (group IV, n = 8). Results. In... (More)
Abstract Objective. This study aimed to reveal the late results of rediversion after urinary diversion. Material and methods. From 1985 to 2009, 28 patients underwent rediversion at the Department of Urology, Lund University Hospital, Sweden. Median follow-up after rediversion was 147 months (range 7-300 months, interquartile range 63-214). The following rediversions were performed: ileal conduit, cutaneous ureterostomy, ureterosigmoidostomy and rectal bladder to continent cutaneous diversion (group I, n = 17); cutaneous ureterostomy to neobladder (group II, n = 1); ileal conduit and cutaneous ureterostomy to gastric conduit (group III, n = 2); and continent cutaneous diversion and neobladder to ileal conduit (group IV, n = 8). Results. In group I, reoperations were necessary after rediversion in nine of the 17 patients. Excellent functional results were obtained in 14 patients. Two patients, both with Kock pouches, underwent multiple operations and finally required rediversion to an ileal conduit. The sole patient in group II had a ureteric reimplantation owing to ureterointestinal stricture and is now continent but performs clean intermittent catheterization. Both patients in group III underwent reoperations owing to ureteric strictures and renal stones. In group IV, one patient had ureteric stenosis, and one died owing to complications related to later surgery for small bowel obstruction. Conclusions. Complications are common after urinary rediversion, and several of the present patients required reoperations for a variety of reasons. Modern techniques for continent cutaneous diversion can provide excellent functional results. Patients with difficulties in accepting a urostomy bag pose special problems and need extensive information and counselling. (Less)
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organization
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type
Contribution to journal
publication status
published
subject
in
Scandinavian Journal of Urology2013-01-01+01:00
volume
48
issue
1
pages
99 - 104
publisher
Taylor & Francis
external identifiers
  • pmid:23889158
  • wos:000332420100014
  • scopus:84895502869
ISSN
2168-1813
DOI
10.3109/21681805.2013.817485
language
English
LU publication?
yes
id
60027405-7ffc-4b6b-95f9-e07b2c4eb4a8 (old id 3955568)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/23889158?dopt=Abstract
date added to LUP
2013-08-02 13:22:03
date last changed
2017-02-22 11:44:01
@article{60027405-7ffc-4b6b-95f9-e07b2c4eb4a8,
  abstract     = {Abstract Objective. This study aimed to reveal the late results of rediversion after urinary diversion. Material and methods. From 1985 to 2009, 28 patients underwent rediversion at the Department of Urology, Lund University Hospital, Sweden. Median follow-up after rediversion was 147 months (range 7-300 months, interquartile range 63-214). The following rediversions were performed: ileal conduit, cutaneous ureterostomy, ureterosigmoidostomy and rectal bladder to continent cutaneous diversion (group I, n = 17); cutaneous ureterostomy to neobladder (group II, n = 1); ileal conduit and cutaneous ureterostomy to gastric conduit (group III, n = 2); and continent cutaneous diversion and neobladder to ileal conduit (group IV, n = 8). Results. In group I, reoperations were necessary after rediversion in nine of the 17 patients. Excellent functional results were obtained in 14 patients. Two patients, both with Kock pouches, underwent multiple operations and finally required rediversion to an ileal conduit. The sole patient in group II had a ureteric reimplantation owing to ureterointestinal stricture and is now continent but performs clean intermittent catheterization. Both patients in group III underwent reoperations owing to ureteric strictures and renal stones. In group IV, one patient had ureteric stenosis, and one died owing to complications related to later surgery for small bowel obstruction. Conclusions. Complications are common after urinary rediversion, and several of the present patients required reoperations for a variety of reasons. Modern techniques for continent cutaneous diversion can provide excellent functional results. Patients with difficulties in accepting a urostomy bag pose special problems and need extensive information and counselling.},
  author       = {Liedberg, Fredrik and Colleen, Stig and Davidsson, Thomas and Månsson, Wiking},
  issn         = {2168-1813},
  language     = {eng},
  number       = {1},
  pages        = {99--104},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Journal of Urology2013-01-01+01:00},
  title        = {Rediversion after urinary diversion: A single-centre experience.},
  url          = {http://dx.doi.org/10.3109/21681805.2013.817485},
  volume       = {48},
  year         = {2014},
}