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Routine pouchograms are not necessary after continent urinary diversion
Murali K Ankem1, Ken-Ryu Han, Victor Hartanto
1Division of Urology, Department of Surgery, University of Medicine and Dentistry of New Jersey Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
Urology
|March 19, 2004
Summary
Routine pouchograms after continent urinary diversion may not be necessary. Most leaks were clinically suspected, and pouchograms (postoperative imaging) rarely identified new issues, sometimes causing complications like urosepsis.
Area of Science:
- Urology
- Surgical Oncology
Background:
- Continent urinary diversion is a common procedure following radical cystectomy.
- Pouchograms are traditionally performed to assess for leaks before catheter removal.
Purpose of the Study:
- To evaluate the necessity of routine pouchograms after continent urinary diversion.
- To assess the diagnostic yield and complication rate of pouchograms.
Main Methods:
- Retrospective review of 72 patients who underwent radical cystectomy and continent urinary diversion between 1991 and 2001.
- Analysis of patient records and postoperative radiographic studies (pouchograms).
Main Results:
- Six patients (8.3%) had radiographic leaks, but 5 were clinically suspected beforehand.
- Three patients (4.7%) developed urosepsis following the pouchogram procedure.
- Pouchograms were performed a median of 22 days postoperatively.
Conclusions:
- Routine pouchograms may not be necessary for patients undergoing continent urinary diversion.
- Clinical assessment appears sufficient for detecting most urinary leaks.
- The risk of complications like urosepsis should be considered.