Urostomal ileal conduit complications in association with abdominal wall mesh implantation

Scand J Urol. 2022 Feb;56(1):1-5. doi: 10.1080/21681805.2021.1986571. Epub 2021 Oct 8.

Abstract

Objective: Parastomal hernia (PH) in association with an ileal conduit is a common complication that is difficult to treat. Mesh reinforcement has been suggested to improve outcomes; either as prophylaxis or for treatment of a parastomal hernia during abdominal wall reconstruction.

Patients and methods: A retrospective study was performed in consecutive patients subjected to mesh implantation between 2000 and 2016 having a concurrent or previous ileal conduit reconstruction. Postoperative and late urostomal complications, as well as hernia occurrence, were ascertained by a chart review of patients' records.

Results: A total of 25 patients were included of whom 13 (52%) developed either a urostomal complication, a PH, or both. Complications were caused by mesh erosion in four patients, of which three were diagnosed more than five years after surgery. Four patients developed a urostomal stenosis. One out of eight patients with urostomal complications were subjected to a new ileal conduit reconstruction and another four to other types of revisional surgery.

Conclusions: Every second patient with an ileal conduit developed either a local urostomal complication, a PH, or both after abdominal wall mesh reconstruction. A careful and cautious attitude towards the use of mesh in patients with an ileal conduit is suggested.

Keywords: Ileal conduit; complications; mesh implantation; parastomal hernia.

MeSH terms

  • Abdominal Wall* / surgery
  • Cystectomy / adverse effects
  • Humans
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Surgical Mesh / adverse effects
  • Surgical Stomas* / adverse effects
  • Urinary Diversion* / adverse effects