Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2011 Nov 1;8(12):667-77.
doi: 10.1038/nrurol.2011.147.

Complications Associated With Urinary Diversion

Affiliations
Review

Complications Associated With Urinary Diversion

Richard E Hautmann et al. Nat Rev Urol. .

Abstract

Radical cystectomy (RC) with subsequent urinary diversion has been assessed to be the most difficult surgical procedure in the field of urology. No randomized trials have been performed to compare the outcomes of noncontinent conduit diversion, neobladder construction and continent cutaneous diversion. Almost all studies are of level 3 evidence, meaning the recommendations given in this Review are of grade C only. Until recently, significant disparity in the quality of surgical complication reporting, as well as the lack of universally accepted reporting guidelines, definitions and grading systems, have made it impossible to compare the surgical morbidity and outcomes of RC. There is a clear case for the standardized reporting of complications. The Clavien system is a straightforward and validated instrument that has already been successfully adopted by several urological centers. Surgical morbidity following RC is significant and, when strict reporting guidelines are incorporated, much higher than previously published. Complications can occur up to 20 years after surgery, emphasizing the need for more long-term studies to determine the full morbidity spectrum. In general, renal function after construction of continent detubularized reservoirs compares favorably with ileal conduit diversion, although the literature is insufficient to recommend one over the other. The challenge of optimum care for elderly patients with comorbidities is best mastered at a high-volume hospital by a high-volume surgeon.

Similar articles

See all similar articles

Cited by 18 articles

See all "Cited by" articles

References

    1. J Urol. 2003 Jun;169(6):2188-91 - PubMed
    1. BJU Int. 2004 Feb;93(3):266-70 - PubMed
    1. BJU Int. 2005 Jun;95(9):1289-92 - PubMed
    1. Int Urogynecol J Pelvic Floor Dysfunct. 2000;11(4):224-9; discussion 230 - PubMed
    1. Urology. 2006 Jul;68(1):58-64 - PubMed
Feedback