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Radical cystectomy involves a urinary diversion, the most used being the ileal conduit and the orthotopic neobladder. This review focuses on the complications associated with these procedures, dividing them into general and diversion related complications, as well as their management. We conducted a search on PubMed and Scopus to identify eligible articles on complications of urinary diversions. Randomized controlled trials and systematic reviews with meta-analysis were preferred when available. Early complications occur in the first 90 days after surgery. The most common is post-operative ileus, followed by urinary tract infections and urinary leakage. Most complications occur in the late post-operative setting, being related to the type of urinary diversion. Some of these complications are renal failure, metabolic abnormalities, infections, urolithiasis, and ureteroenteric strictures, each with particular management options. Specific ileal conduit complications are conduit deformities and parastomal hernias. Neobladder patients can have continence problems, like incontinence or urinary retention, but also fistulas and dehiscence. Standardization of complications' definitions and time-dependent reporting are crucial to better understand and manage these complications. Complication rates are similar between open and robot-assisted procedures and between intracorporeal and extracorporeal diversion. Radical cystectomy with urinary diversion is the most difficult surgical procedure in urology with high early and late complication rates. There is an urgent need of standardizing complication reporting to better compare different procedures.

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INTRODUÇÃO: O colesteatoma do canal auditivo externo é raro e muitas vezes assintomático apesar da insidiosa destruição óssea que vai causando no canal auditivo externo e estruturas vizinhas. Relatos de doença bilateral são episódicos e de causa idiopática. A keratosis obturans é o principal diagnóstico diferencial.CASO CLÍNICO: Criança, 13 anos, com colesteatoma bilateral do canal auditivo externo, com invasão da mastoide e erosão da cadeia ossicular no ouvido esquerdo. A doente apresentava quadro arrastado de otalgia bilateral, com otorreia esporádica e hipoacusia progressiva à esquerda. Após vários procedimentos cirúrgicos para erradicação da doença, mantém-se em vigilância anual sem recidiva aos 4 anos.CONCLUSÃO: Este caso realça a necessidade do reconhecimento precoce desta entidade pouco frequente, mas que pode cursar com lesões extensas e até irreversíveis. O tratamento cirúrgico é curativo, mas a vigilância regular é mandatória.

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