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Introduction: We evaluated complications and patient satisfaction following supravesical urinary diversion for non-bladder cancer indications.
Materials & Methods: This IRB approved retrospective study was performed in 26 females and 10 males who underwent ileal loop diversion for non-bladder cancer indications by a single surgeon between 1999 to 2010. Charts were reviewed and patients were contacted to assess outcomes, complications and satisfaction following surgery.
Results:Of the 36 patients, indications for urinary diversion were: neurogenic bladder (18), radiation cystitis (11), prostatic brachytherapy complications (3), refractory incontinence (3) and recurrent urinary tract infection (1). All patients were left with their native bladders. Complications occurred in 18 patients (50%) including: UTI (25%), ureteral stenosis (19%), stomal hernia (14%), pyocystis (8%), bowel leak, (6%), and nephrolithiasis (6%). Fourteen patients were deceased at time of our review (mean 27 months after surgery). Nineteen of the surviving 22 patients (86%) were interviewed. Their mean age was 62 years and mean time from surgery was 39 months. Patients had a mean overall satisfaction score of 8.63 + 1.83 on a scale from 0-10 (10 = most satisfied). When asked if they would repeat the surgery 14 (74%) said yes, 2 (11%) said no, and 3 (16%) said they were unsure.
Conclusions:In selected patients, ileal loop diversion can be used to manage recalcitrant lower urinary tract complications. Despite a relatively high complication rate, long-term patient satisfaction remains high. The bladder may be left in place given the low pyocystis rate.