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[Abdominal pain in patients undergoing radical cystectomy for bladder cancer]
F Herranz Amo1, J M Díez Cordero, F Verdú Tartajo
1Servicio de Urología, Hospital General Universitario Gregorio Marañón, Madrid, España.
Objective:
To analyze the incidence and causes of emergency admission for abdominal pain in patients submitted to radical cystectomy for bladder cancer.
Methods:
A retrospective study was conducted on 176 patients who had undergone radical cystectomy for bladder cancer. The preoperative treatment, urinary diversion procedure, postoperative tumor stage, complications and adjuvant treatment required were analyzed. The patients had a follow-up of 43.7-58.3 months (mean 51).
Results:
18 patients required admission for abdominal pain; 7 for complete bowel obstruction, 5 for partial obstruction of the intestine and 6 for intestinal fistula (4 to the neobladder, 1 to the urethra, and 1 to the vagina). In 6 patients abdominal pain was caused by recurrence of a pelvic tumor. Seven patients required emergency surgery and 5 elective surgery.
Conclusions:
10.5% of the patients who had undergone radical cystectomy for bladder cancer had at least one episode of abdominal pain requiring admission to hospital. During the first 6 months postoperatively, partial obstruction of the intestine was the most common cause of abdominal pain, and thereafter, complete bowel obstruction and intestinal fistula to the neobladder. Abdominal pain was caused by recurrence of a pelvic tumor in 33% of the patients and by a benign condition in the remaining patients. We found no risk factors related with the preoperative treatment, tumor, urinary diversion procedure or early complications that may predispose to episodes of abdominal pain.