Management of Urinary and Bowel Complications after Ileal Conduit Diversion

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Abstract
Serious urinary and bowel complications after ileal conduit diversion are associated with significant morbidity and mortality rates. Nine patients treated during the last 5 yr were reviewed for sequelae after ileal conduit diversion for bladder cancer. Of these patients, 8 are well and 1 died postoperatively of myocardial infarction. In all, 33 operations were required to treat complications after initial diversion. A variety of surgical procedures, including anastomotic revision, ileal ureter, stomal revision, transverse colon conduit and nephrectomy, was used to treat urinary complictions. A treatment outline emphasizing an initial conservative approach, the importance of nutritional support and the appropriate options for reconstruction is presented.