Comparative Study of Various Forms of Urinary Diversion after Radical Cystectomy in Muscle
Abstract
Objective: To compare the three types of urinary diversion namely Ileal Conduit, MAINZ Pouch II and Ileal Neobladder in terms
of patient preference, post-operative hospital stay, early and late complications, continence rates, quality of life and patient
satisfaction.
Method: From January 2003 to October 2007, 30 patients (28 males and 2 females) of muscle invasive carcinoma urinary bladder
(mean age 57.7 years) were operated upon by radical cysto- prostatectomy or anterior pelvic exenteration and urinary diversion
was performed by Ileal conduit, Mainz pouch II or Ileal neobladder. The patient preference for the type of diversion was determined
pre-operatively after discussing all the three types of urinary diversions. Post-operative hospital stay, early and late complications,
continence rates, quality of life and patient satisfaction with the type of diversion were evaluated on follow up.
Results: 60% of the patient’s preferred Ileal neobladder, 10% preferred Ileal conduit and 10% preferred Mainz pouch II as their
1st choice diversion; 20% left the decision to the operating surgeon. The mean post-operative hospital stay was 15.0 days in
Ileal conduit group, 17.8 days in Mainz pouch II group and 19.7 days in Ileal neobladder group. The mean follow up was 27.7
months. Early complications (within 1 month of surgery) were observed in 46.2% of patients in Ileal conduit group, 38.5% in
Mainz pouch II group and 50.0% in Ileal neobladder group. Late complications (after 1 month of surgery) were seen in 61.5% of
patients in Ileal conduit group, 46.2% in Mainz pouch II group and 50.0% in Ileal neobladder group. In Mainz pouch II group
92.3% of the patients achieved daytime continence and 84.6% achieved night time continence 3 to 6 months after surgery. In
Ileal neobladder group, 75.0% patients achieved day time continence and 50.0% achieved night time continence 3 to 6 months
after surgery. Patient satisfaction and overall quality of life was described ‘Good’ by majority of patients in Ileal conduit group
and ‘Very Good’ by majority of patients in Mainz pouch II group and Ileal neobladder group.
Conclusion: There are inherited advantages and disadvantages to each form of urinary diversion and patient selection is
important to identify the most appropriate method of diversion for an individual.
of patient preference, post-operative hospital stay, early and late complications, continence rates, quality of life and patient
satisfaction.
Method: From January 2003 to October 2007, 30 patients (28 males and 2 females) of muscle invasive carcinoma urinary bladder
(mean age 57.7 years) were operated upon by radical cysto- prostatectomy or anterior pelvic exenteration and urinary diversion
was performed by Ileal conduit, Mainz pouch II or Ileal neobladder. The patient preference for the type of diversion was determined
pre-operatively after discussing all the three types of urinary diversions. Post-operative hospital stay, early and late complications,
continence rates, quality of life and patient satisfaction with the type of diversion were evaluated on follow up.
Results: 60% of the patient’s preferred Ileal neobladder, 10% preferred Ileal conduit and 10% preferred Mainz pouch II as their
1st choice diversion; 20% left the decision to the operating surgeon. The mean post-operative hospital stay was 15.0 days in
Ileal conduit group, 17.8 days in Mainz pouch II group and 19.7 days in Ileal neobladder group. The mean follow up was 27.7
months. Early complications (within 1 month of surgery) were observed in 46.2% of patients in Ileal conduit group, 38.5% in
Mainz pouch II group and 50.0% in Ileal neobladder group. Late complications (after 1 month of surgery) were seen in 61.5% of
patients in Ileal conduit group, 46.2% in Mainz pouch II group and 50.0% in Ileal neobladder group. In Mainz pouch II group
92.3% of the patients achieved daytime continence and 84.6% achieved night time continence 3 to 6 months after surgery. In
Ileal neobladder group, 75.0% patients achieved day time continence and 50.0% achieved night time continence 3 to 6 months
after surgery. Patient satisfaction and overall quality of life was described ‘Good’ by majority of patients in Ileal conduit group
and ‘Very Good’ by majority of patients in Mainz pouch II group and Ileal neobladder group.
Conclusion: There are inherited advantages and disadvantages to each form of urinary diversion and patient selection is
important to identify the most appropriate method of diversion for an individual.
Sherwani, A. Y., Wazir, B. S., Hamid, A., Wani, M. S., & Aziz, R. (2009). Comparative Study of Various Forms of Urinary Diversion after Radical Cystectomy in Muscle. International Journal of Health Sciences, 3(1). Retrieved from https://pub.qu.edu.sa/index.php/journal/article/view/24
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