Faculty Collaboration Database

Incontinent ileovesicostomy: Long-term outcomes and complications. Neurourol Urodyn 2009;28(6):483-6

Date

03/11/2009

Pubmed ID

19274757

DOI

10.1002/nau.20695

Scopus ID

2-s2.0-70049116613 (requires institutional sign-in at Scopus site)   25 Citations

Abstract

AIMS: Incontinent ileovesicostomy was popularized in the mid-1990s as a surgical option for patients with neurogenic voiding dysfunction who lack the dexterity to perform clean catheterization. There are several case series in the literature, but few studies look at the long-term outcomes and complications associated with this procedure.

METHODS: We review the outcomes of 12 patients who underwent incontinent ileovesicostomy for management of neurogenic voiding dysfunction since its introduction at our institution in 1998. We discuss, specifically, the preoperative and postoperative problems encountered as well as complications pertaining to ileovesicostomy itself.

RESULTS: At an average of 5 1/2 years follow-up, all 12 patients who underwent incontinent ileovesicostomy have experienced some form of urinary tract problem either associated with the ileovesicostomy or with their underlying neurogenic voiding dysfunction. After ileovesicostomy, seven of 12 patients (58%) have been able to reduce antibiotic usage and/or hospital admission related to chronic upper tract infection. Two patients (17%) have subsequently been converted to ileal conduit.

CONCLUSIONS: Incontinent ileovesicostomy is a useful option for patients with lower urinary tract dysfunction who are unable to perform clean intermittent catheterization. It should be reserved for those patients who have exhausted less invasive therapy and in whom quality of life benefits cannot be achieved without diversion. Experience shows that there are no absolute indications for this procedure. The clinician and the patient must be aware of the importance of continued surveillance after this procedure for problems related to neurogenic voiding dysfunction and/or the ileovesicostomy itself.

Author List

Hellenthal NJ, Short SS, O'Connor RC, Eandi JA, Yap SA, Stone AR

Author

Robert Corey O'Connor MD Professor in the Urologic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Anti-Bacterial Agents
Cystostomy
Female
Humans
Ileostomy
Male
Middle Aged
Patient Selection
Quality of Life
Recurrence
Retrospective Studies
Risk Assessment
Time Factors
Treatment Outcome
Urinary Bladder Calculi
Urinary Bladder, Neurogenic
Urinary Catheterization
Urinary Tract Infections
Urodynamics