[Usefulness of catheter pyelography in ileal diversions and continent bladder replacement after radical cystectomy]

Transcatheter ascending pyelography is commonly performed in the post-operative evaluation of patients submitted to ileal diversion or continent bladder replacement after radical cystectomy. The present study investigated the usefulness of this procedure in the control of these patients. Of 51 patients that underwent cutaneous ileal diversion, the IVP revealed a leak of the contrast medium in only one case (1.9%). Of the 18 patients that received a continent neobladder, radiologic signs of changes were detected in 6 cases (33.3%). The complications of the IVP in our patients were fever in 26 patients (37.7%) and septicemia in one patient (1.45%). Considering the information obtained and the rate of morbility, we believe that ascending pyelography through catheters is not justified in the routine post-operative control of patients who have undergone radical cystectomy and ileal diversion. However, it appears to be a useful procedure in those cases that have undergone bladder replacement and/or continent diversion procedures.