Early and late complications of ileal condiut urinary diversion

The early and late complications of cutaneous uretero-ileostomy in 61 patients are reported. Only complications attributable to the urinary diversion procedure are detailed. The early complications included intestinal obstruction in 4 cases, enterocutaneous fistula in 4, urinary fistula in 6 and wound disruption in 3 cases The surgical mortality was 6.6%. The predominant late complications were uretero-ileal obstruction with progressive hydronephrosis in 14 patients, 8 of whom underwent re-operation. Stomal problems arose in 6 patients and stone in the urinary tract in 5 patients. Full preoperative irradiation and isolated anastomosis between the ureters and the ileal segment increased the frequency of these late complications. Some measures are discussed which may reduce this fairly high complication rate.