Continent catheterizable vesicostomy in an adult population: Success at high costs

Abstract

Continent urinary diversion in an adult population is associated with a high complication and revision rate. Although conversion rate to an ileal conduit is appreciable, the majority of patients (26/35) finally achieve full continence and unobstructed access to the bladder.

Continent catheterizable vesicostomy in adults: Initial experience at a Scandinavian tertiary referral centre

“…These conclusions tally with the findings of De Ganck et al, who reported that although the complication rate for continent smalldiameter stoma was high in their series, most complications were relatively easy to treat, finally yielding a high level of patient satisfaction [18]. Moreover, in the series of Van der Aa [17], six patients were undiverted, one had an indwelling catheter and two had supplementary sacral neuromodulation. Only two underwent concomitant bladder neck closure, a low percentage in line with the experience in the present series.…”

“…However, Liard et al reported that after 20 years revisions tended to be more common, with a considerable percentage of patients ending up with a Bricker diversion [16]. Van der Aa et al reported on a series of 35 patients [17]. Their series comprised a variety of patient types and they used several methods to fashion the continent catheterizable vesicostomy.…”

Long‐term complications of continent cutaneous urinary diversion in adult spinal cord injured patients

“…We found a stomal continence rate of 100%, which is similar to that in other reports. In some studies, stomal incontinence can reach 9–22% . Our lower rate of stomal incontinence may be explained by implantation of the tube in a preserved postero‐lateral bladder‐wall flap using an anti‐reflux system via a submucosal channel, according to the Politano–Leadbetter principle.…”

Continent catheterizable tubes/stomas in adult neuro-urological patients: A systematic review

“…Stenosis and resulting difficulty to catheterize were the main specific complications of CSS/T observed in up to 23% of the neuro‐urological case series we reviewed. Although underreporting is very likely, this stenosis rate must be compared with a median rate ranging from 9% to 21% in the largest non neuro‐urological specific review with an equivalent rate of difficulty to catheterize or with the highest 28% stenosis rate reported in a case series which included 50% of neuro‐urological patients with a 6‐year follow‐up . The difference between CSS/T techniques (tubes, invaginated valves, or non‐invaginated valves) regarding the stenosis rate was not assessed in the neuro‐urological patient series and was not different in the review by Ardelt et al…”