Feasibility of urolithiasis management after studer neobladder urinary diversion: A multicenter center study

Abstract

Background: Stones formation is a common complication after cystectomy including stones of the upper urinary tract and reservoir or conduit. Advances in instrumentation and techniques have expanded treatment options, while minimizing morbidity. Aims and Objectives: Feasibility of urolithiasis management after urinary diversion surgery. Materials and Methods: Eleven patients of diversion with stone were observed from January 01, 2015, to July 30, 2022. Operative procedures were decided on basis on stone locations and size. Perioperative parameters were observed and compared with similar studies. Percutaneous nephrolithotomy, percutaneous-based antegrade ureteroscopy with semi-rigid or flexible ureteroscope, transurethral reservoir lithotripsy, percutaneous pouch lithotripsy, and open operation were performed. The operative finding and complications were retrospectively collected and analyzed. Results: The mean age of the patients was 53.2±8.1 years and mean pre-operative stone diameter was 3.1±3.5 cm. Three patients suprapubic cystolithotomy, two patients percutaneous cystolithotripsy, two patients percutaneous nephrolithitomy, two patients extracorporeal shock wave lithotripsy, one patient per urethral cystolithotripsy/cystolitholapexy, and one patient ureteroscopy/flexible ureteroscopy were done. The male-to-female ratio was 9/2. Stone-free rate was 100% after single session of treatment. In the post-operative period, fever was observed in two patients, and urinary leakage through wound site in one patient. Conclusion: Stone surgery after urinary diversion is challenging, success of treatment depends on experience of surgical team, pre-operative preparation, and correct instrumentations.