Management of urinary and bowel complications after ileal conduit diversion

Serious urinary and bowel complications after ileal conduit diversion are associated with significant morbidity and mortality rates. We reviewed 9 patients treated at our institution during the last 5 years for sequelae after ileal conduit diversion for bladder cancer. Of these patients 8 are well and 1 died postoperatively of a myocardial infarction. In all, 33 operations were required to treat complications after initial diversion. A variety of surgical procedures, including anastomotic revision, ileal ureter, stomal revision, transverse colon conduit and nephrectomy, was used to treat urinary complications. A treatment outline emphasizing an initial conservative approach, the importance of nutritional support and the appropriate options for reconstruction is presented.