Parastomal hernia after ileal conduit urinary diversion: re-visiting the predictors radiologically and according to patient-reported outcome measures

Harraz, Ahmed M.; Elkarta, Ahmed; Zahran, Mohamed H; Elsawy, Amr A.; Elbaset, M. A.; Elsorougy, Ali; Osman, Yasser; Mosbah, Ahmed; Abol‐Enein, Hassan; Shaaban, Atallah A.

doi:10.1080/21681805.2020.1832144

Cited by 11 publications

(8 citation statements)

References 46 publications

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“…Another limitation of the present study is that the trial did not include any PSH-specific outcome measures, such as hernia-related problems with stoma appliances or local pain; however, only a minority of patients with PSH are asymptomatic [21] . Furthermore, the lack of a more structured definition for clinical PSH, such as the European Hernia Society stratification of PSH based on hernia size that was applied in the aforementioned study [21] , is a study limitation. Similarly, no generic or disease-specific instrument for measuring patient quality of life was available for the CEA.…”

Section: Discussionmentioning

confidence: 99%

Cost Effectiveness of the Use of Prophylactic Mesh To Prevent Parastomal Hernia After Urinary Diversion with an Ileal Conduit

Saha

Gerdtham

Bläckberg

et al. 2022

European Urology Open Science

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Section: Discussionmentioning

confidence: 99%

Cost Effectiveness of the Use of Prophylactic Mesh To Prevent Parastomal Hernia After Urinary Diversion with an Ileal Conduit

Saha

Gerdtham

Bläckberg

et al. 2022

European Urology Open Science

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“…M€ ak€ ar€ ainen-Uhlb€ ack, J. Vironen, M. Vaarala, P. Nordstr€ om, A. V€ alikoski, J. K€ ossi, V. Falenius, A. Kechagias, A. Mattila, P. Ohtonen, T. Scheinin and T. Rautio Division of Surgery, Medical Research Center, Oulu University Hospital, University of Oulu, Oulu, Finland, Abdominal Center, Helsinki University Hospital, Helsinki, Finland, Division of Surgery, Gastroenterology, and Oncology, Tampere University Hospital, Tampere, Finland, Division of Surgery, P€ aij€ at-H€ ame Central Hospital, Lahti, Finland, Division of Surgery, University of Turku, Turku, Finland, Division of Surgery, Kanta-H€ ame Central Hospital, H€ ameenlinna, Finland, Division of Surgery, Central Finland Central Hospital, Jyv€ askyl€ a, Finland Editorial Comment: Parastomal hernia (PSH) occurs in approximately 20% of patients after ileal conduit urinary diversion and is symptomatic in 34%e86%. 1,2 The detected PSH rate varies with the definition of PSHdwhether it is based on physical examination or computerized tomography. Signs and symptoms can include pain, bloating, urostomy obstruction, problems with urostomy appliance fit and, rarely, bowel obstruction.…”

Section: Re: Keyhole Versus Sugarbaker Techniques In Parastomal Herni...mentioning

confidence: 99%

“…Risk factors include obesity, female gender, low albumin and previous laparotomy (before the cystectomy). 1,2 Herein we will discuss a few recently published articles that review incidence and risk factors for PSH (Su et al), success rates with different types of PSH repair (M€ ak€ ar€ ainen-Uhlb€ ack et al) and the role of prophylactic mesh placement at the time of conduit creation (Liedberg et al).…”

Section: Re: Keyhole Versus Sugarbaker Techniques In Parastomal Herni...mentioning

confidence: 99%

Trauma, and Genital and Urethral Reconstruction

Elliott¹

2022

Journal of Urology

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Editorial Comment: Medicare Advantage has proliferated over the past decade, with 39% of all Medicare beneficiaries now enrolled in the program. 1 Medicare Advantage plans typically create curated provider networks in an effort to reduce cost and improve quality. Nonetheless, the extent to which Medicare Advantage systematically limits access to designated "high quality" hospitals remains poorly characterized. This study compared the use of the 50 top-ranked U.S. cancer hospitals between Medicare Advantage and fee-for-service Medicare beneficiaries. The investigators found that Medicare Advantage members undergoing thoracic or abdominal cancer surgery were 6% (95% CI 4.7%À7.2%) less likely to use a top-ranked cancer hospital than beneficiaries enrolled in fee-for-service Medicare. This difference was higher among Medicare Advantage members in plans without out-of-network benefits.This study highlights the tradeoffs between choice and cost in the Medicare program. Whereas feefor-service Medicare affords beneficiaries choice, it comes with a significant cost-sharing component. Medicare Advantage often requires little to no out-of-pocket cost sharing from patients; however, the narrower provider and hospital networks in Medicare Advantage programs limit patient choice. While these data suggest that Medicare Advantage members are less likely to undergo surgery at top-ranked hospitals, the study does not evaluate between-group differences in outcomes. As such, whether the intermediate outcome of hospital use maps to meaningful outcomes remains largely unknown.

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“…This bulge is caused by the protrusion of intra-abdominal content (fat, intestine, colon) through the abdominal wall defect that allows the passage of the ileal conduit to the skin stoma (Fig 1). PH is the most common stomal complication after RC, but its real incidence is not known as it may vary from 10 to 50% according to various series 4 [2,4,[6][7][8][9][10][11][12]. As other incisional hernias, most PH developed within the first two years after RC [9,[12][13][14].…”

Section: Natural History and Risk Factorsmentioning

confidence: 99%

Parastomal hernia after radical cystectomy with ileal conduit diversion: a narrative review

Goffioul

Bonnet

Waltregny

et al. 2021

Acta Chirurgica Belgica

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Radical cystectomy (RC) with ileal conduit urinary diversion has become a common surgical procedure. Stomal complications and particularly parastomal hernia (PH), are the most frequent complications and causes of reintervention after RC with ileal conduit urinary diversion. PH is usually asymptomatic. When PH increases in size and becomes symptomatic, it clearly impairs patients' quality of life in terms of physical limitation, mental distress and social interaction. The aim of this paper was to review the current knowledge on PH after RC with ileal conduit urinary diversion, regarding its natural history, risk factors, prevention and surgical management. There is no strong recommendation on the ideal surgical technique for repair of PH after RC, but laparoscopic Sugarbaker or Sandwich techniques with nonabsorbable meshes are emerging as the preferred modern means of PH repair. Techniques for prevention and repair of PH after RC need to be specifically evaluated in future prospective studies.

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Parastomal hernia after ileal conduit urinary diversion: re-visiting the predictors radiologically and according to patient-reported outcome measures

Cited by 11 publications

References 46 publications

Cost Effectiveness of the Use of Prophylactic Mesh To Prevent Parastomal Hernia After Urinary Diversion with an Ileal Conduit

Cost Effectiveness of the Use of Prophylactic Mesh To Prevent Parastomal Hernia After Urinary Diversion with an Ileal Conduit

Trauma, and Genital and Urethral Reconstruction

Parastomal hernia after radical cystectomy with ileal conduit diversion: a narrative review

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