Purpose Of Review: This review is timely and relevant because many patients live many years with urinary diversions. Knowledge about the long term outcome with respect to function and complications are important for patient counseling and for the manner to follow-up patients. This study was performed to investigate the functioning of urinary diversions constructed > 25 years earlier.
Recent Findings: Most studies have a relatively shorter follow-up, mainly focussing on short term postoperative complications. Focussing on the long term, urinary tract infections (UTI) including pyelonephritis are common. Mild kidney function deterioration is described.
Summary: Retrospective study (2018-2019); 43 patients with regular follow-up at the Radboud University Medical Centre Nijmegen the Netherlands. Ileal conduit (n = 19) and ureterosigmoidostomy (n = 11) are the most common diversion types for reasons such as: bladder exstrophy (n = 15), urinary incontinence (n = 9) and malignancy (n = 8). This series with a median follow-up of 40 years, shows it is possible to live and cope with a urinary diversion for a very long time. Ureterosigmoidostomies give relatively good results. Ileal conduits are functioning properly with acceptable complication rates. 95% suffers from chronic UTI's. Kidney function deterioration was mild. Diversions for benign reasons have more complex complications compared to diversion constructed for malignant reasons.
Video Abstract: http://links.lww.com/COU/A32.
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http://dx.doi.org/10.1097/MOU.0000000000000928 | DOI Listing |
Nephrology (Carlton)
January 2025
Department of Transplant, Mayo Clinic Florida, Jacksonville, Florida, USA.
Ureteral stenosis is a frequent complication after kidney transplantation, causing significant morbidity and potential graft function impairment. Treatment options include conservative management, endourological procedures, surgical interventions and percutaneous nephrostomy (PCN). While PCN effectively relieves obstruction, it comes with its own complications.
View Article and Find Full Text PDFArch Esp Urol
December 2024
Department of Urology, The Affiliated Hospital of Qingdao University, 266000 Qingdao, Shandong, China.
Background: Hemorrhage is the most common and dangerous complication after percutaneous nephrolithotripsy (PCNL). Therefore, this study introduces the management experience of bleeding complications in our center.
Methods: This retrospective study included 77 patients with severe bleeding after PCNL.
Int J Urol
January 2025
Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Introduction: Bowel regimens (BR) before radical cystectomy (RC) are currently not recommended by Enhanced Recovery After Surgery (ERAS) protocols, as prior studies have shown BRs lead to worsened outcomes. However, many of those studies have used historic literature before recent surgical advancements such as minimally invasive RC and have not investigated the impact BRs have by type of urinary diversion. Our goal is to determine the outcomes of preoperative BR in patients undergoing RC based on diversion type using a modern patient cohort.
View Article and Find Full Text PDFUrolithiasis
January 2025
Urology Department, Benha University, Benha, Qalubia, Egypt.
Studies in literature discussed the drawbacks of the ureteral access sheath use in flexible ureteroscopy and in the same time mentioned the benefits of ureteral access sheath in decreasing the incidence of urosepsis and better stone free rate. In the current study we aim to compare between percutaneous nephrostomy tube (PCN) insertion before flexible ureteroscopy and conventional ureteral access sheath (UAS) flexible ureteroscopy in terms of safety, efficacy and perioperative outcomes. In all, 100 Patients aged 20 to 67 years with upper ureteric stones and mild hydronephrosis or renal pelvic stones less than 20 mm with mild hydronephrosis were randomized into 2 groups; patients undergoing PCN insertion before flexible ureteroscopy, and patients undergoing the conventional UAS flexible ureteroscopy.
View Article and Find Full Text PDFIntroduction: Gastroenterocolitis is one of the adverse events related to immune checkpoint inhibitors. However, inflammation of the intestinal lesion used for urinary diversion is not well known as an adverse event related to their use.
Case Presentation: A patient with metastatic bladder cancer was administered pembrolizumab as second-line treatment.
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