Tumor Growth in Urinary Diversion: A Multicenter Analysis

Kälble, T.; Hofmann, I.; Riedmiller, H.; Vergho, Daniel

doi:10.1016/j.eururo.2011.07.006

Cited by 77 publications

(41 citation statements)

References 17 publications

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“…However, the true incidence of this phenomenon is very difficult to determine, because most of the cases published in the literature are single institutional series or case reports. Käble et al designed the only study that gathers data from several urological clinics and tries to establish a relation between the type of urinary diversion and the risk of malignant transformation 3. Besides ureterosigmoidostomy, secondary tumour risk was also significantly higher (13-fold to be exact) in ileocystoplasty compared to other forms of intestine interposition for urinary tract reconstruction.…”

Section: Discussionmentioning

confidence: 99%

Intestinal adenocarcinoma in an augmented ileocystoplasty

et al. 2013

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We present a case of a 67-year-old patient with a history of augmentation ileocystoplasty 31 years ago following genitourinary tuberculosis. Radiological investigations performed due to asymptomatic microscopic haematuria revealed three contrast-enhancing polyps within the neobladder. The patient had enterocystoprostatectomy and histopathological examination of the neobladder revealed mucinous adenocarcinoma in all three polyps, together with a prostatic adenocarcinoma Gleason 7 (3+4). After adjuvant chemotherapy and 1 year of follow-up, he had no sign of clinical or radiological recurrence. Taking into consideration this rare case, we discuss the development of malignant tumours after the incorporation of intestinal segments in a urinary tract reconstruction, showing what relationship exists between secondary neoplastic growth, the primary disease and the type of urinary diversion utilised.

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Section: Discussionmentioning

confidence: 99%

Intestinal adenocarcinoma in an augmented ileocystoplasty

et al. 2013

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“…The time from surgery to neoplasia diagnosis was 1 to 37 years. 2 The carcinogenic agent in U/sigs is unproven but may be an N-nitroso compound. These compounds are also found in ileal reservoirs when infection is present but not when the urine is sterile.…”

Section: Ileal Conduits and Reservoirsmentioning

confidence: 99%

“…In a German review of 37 years of follow-up from 44 clinics, the incidence of anastomotic tumour was 0.05% for ileal neobladders and 0.02% for ileal conduits, though one was a desmoid tumour. 2 There are also reports of nonanastomotic adenocarcinomas in conduits ( Figure 2). For self-catheterisable ileocaecal pouches there were three tumours in 2181 patients (1.14%), but only one was an adenocarcinoma.…”

Section: Ileal Conduits and Reservoirsmentioning

confidence: 99%

The risks of cancer after bladder replacement or diversion

Woodhouse¹

2018

Trends Urol & Men's Health

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“…Zu einem späte-ren Zeitpunkt auftretende Stenosen der Harnleiterdarmanastomose entwickeln sich meist asymptomatisch und sind verdächtig auf das Vorliegen eines sekundä-ren Tumors, der nach Untersuchungen von Kälble et al [16] bei ilealen Neoblasen und Conduits von der ureterointestinalen Anastomose, bei ileozäkalen Neoblasen und Pouches vom Darmsegement ausgeht. Deshalb sind sowohl postoperativ nach Splintentfernung als auch im weiteren Follow-up regelmäßige Ultraschallkontrollen zum rechtzeitigen Erkennen relevanter Harntransportstörungen notwendig, die ohne Intervention zum dauerhaften Funktionsverlust der Niere führen können.…”

Section: Stenosen Der Ureterointestinalen Anastomoseunclassified

Die ureterointestinale Anastomose

Weingärtner

2012

Urologe

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A well-functioning uretero-intestinal anastomosis is essential for the preservation of kidney function following urinary diversion using bowel segments. In incontinent forms of urinary diversions, such as ileal conduits, the ureters are usually implanted in a refluxive manner, whereas there is still controversy about the ideal implantation technique in continent orthotopic or heterotopic reservoirs (i.e. refluxive versus anti-refluxive). Current techniques of refluxive and antirefluxive uretero-intestinal anastomosis, their indications, typical perioperative and postoperative complications and management are discussed. Irradiated or preoperatively dilated ureters show a higher complication rate in terms of postoperative dilatation and obstruction. Early revision of the implantation site and ureteral reimplantation yield more favorable outcomes and long-term results than a minor invasive endourological treatment. As ureteral stenosis may occur more than 15 years after urinary diversion, regular follow-up including sonographic evaluation of the upper urinary tract to detect hydronephrosis is mandatory. In this setting a diuretic renogram with MAG-III is a helpful tool to determine split renal function and to discriminate urodynamic relevant dilatation of the upper urinary tract from clinical situations requiring only observation, while dimercaptosuccinic acid (DMSA) scans provide valuable information about renal scarring.

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Tumor Growth in Urinary Diversion: A Multicenter Analysis

Cited by 77 publications

References 17 publications

Intestinal adenocarcinoma in an augmented ileocystoplasty

Intestinal adenocarcinoma in an augmented ileocystoplasty

The risks of cancer after bladder replacement or diversion

Die ureterointestinale Anastomose

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