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Related Experiment Videos

Urinary diversion after radical cystectomy.

Peter E Clark1

  • 1Department of Urology, Wake Forest University Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC 27157, USA. petereclark@pol.net

Current Treatment Options in Oncology
|August 27, 2002
PubMed
Summary
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Orthotopic urinary diversion is preferred after radical cystectomy for bladder cancer, prioritizing patient selection based on health and urethral margins. Experienced centers performing all diversion types ensure optimal outcomes.

Area of Science:

  • Urology
  • Surgical Oncology
  • Oncology

Background:

  • Orthotopic urinary diversion is increasingly favored after radical cystectomy for bladder cancer.
  • Patient selection criteria have evolved, shifting from exclusion to careful consideration of suitability.

Purpose of the Study:

  • To outline the current approach and criteria for selecting patients for orthotopic urinary diversion post-cystectomy.
  • To emphasize the importance of surgeon expertise in various urinary diversion techniques.

Main Methods:

  • Review of patient selection criteria for orthotopic diversion.
  • Discussion of contraindications and considerations for eligibility.
  • Emphasis on surgeon's proficiency in multiple diversion techniques.

Related Experiment Videos

Main Results:

  • Orthotopic diversion is suitable for most radical cystectomy patients without chronic renal insufficiency, negative urethral margins, and adequate capacity.
  • Age and locally advanced disease are not absolute contraindications.
  • Surgeon expertise in conduit, continent cutaneous, and orthotopic diversions is crucial.

Conclusions:

  • Careful patient selection is paramount for successful orthotopic urinary diversion.
  • Radical cystectomy and urinary diversion should be performed at high-volume centers with expertise in all major diversion types.