Complications of the ileocolonic continent urinary reservoir (Miami pouch)

Urinary diversion via the continent ileocolonic reservoir has been performed at our institution since February 1988. During a 4-year period, 39 patients have received this procedure as an alternative to other forms of cutaneous urinary diversion at the time of exenteration. We analyze our data in terms of early and late (beyond 6 weeks) complications resulting directly from the operation or from this form of urinary diversion. A total of 18 patients (46%) suffered early complications resulting in an operative mortality rate of 7% (3 of 39 patients). One or more late complications occurred in six patients (15%). Only one patient required reoperation for a postoperative complication. With ongoing experience, problem areas have been identified that have led us to make modifications in technique. We review our experience with the incidence of early and late complications in terms of management and ultimate prevention.