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Related Experiment Videos

Urinary conduits in gynecologic oncology.

K C Hancock, L J Copeland, D M Gershenson

    Obstetrics and Gynecology
    |May 1, 1986
    PubMed
    Summary

    Urinary conduit surgery using gastrointestinal segments, often after pelvic radiotherapy, showed decreasing complications and mortality over 11 years. Key factors for success include bowel tissue quality and mobility.

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    Area of Science:

    • Urology
    • Surgical Oncology
    • Gastroenterology

    Background:

    • Urinary diversion is a critical component of pelvic exenteration and management of radiation-induced injuries.
    • Gastrointestinal segments are commonly utilized for urinary conduit creation, necessitating careful selection.
    • Prior pelvic radiotherapy is a frequent comorbidity in patients requiring urinary diversion.

    Purpose of the Study:

    • To evaluate the outcomes of urinary conduit surgery performed over an 11-year period.
    • To analyze complication rates, mortality, and factors influencing success in urinary diversion procedures.
    • To assess the impact of surgical experience on perioperative outcomes.

    Main Methods:

    • Retrospective review of 212 urinary conduit surgeries performed between 1971 and 1981.

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  • Analysis of patient demographics, indications for surgery, bowel segments used, and perioperative outcomes.
  • Documentation of complications such as infection, renal loss, stomal revision, and fistulae.

    • Main Results:

    • Ileum and sigmoid colon were the most frequently used bowel segments for urinary diversion.
    • Significant improvement in intravenous pyelograms was observed post-diversion in 50% of patients.
    • Overall perioperative mortality decreased from 11% to 3% over the study period, with a 6% stoma revision rate and notable complication rates for infection (18%) and renal loss (17%).

    Conclusions:

    • Urinary conduit surgery, particularly in patients with prior pelvic radiotherapy, can be performed with acceptable morbidity and decreasing mortality.
    • Selection of bowel segments based on tissue quality and mobility is crucial for successful urinary diversion.
    • Surgical experience significantly contributes to improved outcomes in urinary conduit procedures.