MP49-18 EARLY COMPLICATIONS AS A RESULT OF INDIANA POUCH URINARY DIVERSION: A 7 YEAR EXPERIENCE

You have accessJournal of UrologyBladder Cancer: Invasive I (MP49)1 Apr 2020MP49-18 EARLY COMPLICATIONS AS A RESULT OF INDIANA POUCH URINARY DIVERSION: A 7 YEAR EXPERIENCE Ryan Speir*, Ramzy Nagle, Hannah Jarvis, Sean Kern, Clint Cary, Timothy Masterson, Thomas Gardner, Richard Bihrle, Michael Koch, and Hristos Kaimakliotis Ryan Speir*Ryan Speir* More articles by this author , Ramzy NagleRamzy Nagle More articles by this author , Hannah JarvisHannah Jarvis More articles by this author , Sean KernSean Kern More articles by this author , Clint CaryClint Cary More articles by this author , Timothy MastersonTimothy Masterson More articles by this author , Thomas GardnerThomas Gardner More articles by this author , Richard BihrleRichard Bihrle More articles by this author , Michael KochMichael Koch More articles by this author , and Hristos KaimakliotisHristos Kaimakliotis More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000911.018AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Complication rates following cystectomy range from 40-80% with 75% of complications being related to the urinary diversion. Reported complication following continent cutaneous urinary reservoir creation has been reported to be higher than either ileal conduit or orthotopic neobladder creation. We sought out to describe the most recent 7 year experience with 137 consecutive Indiana pouch patients at a single institution. Our goal was to provide updated data on early complications with this type of urinary diversion during the first postoperative year. METHODS: Our prospectively maintained bladder cancer database was queried to identify all patients who underwent cystectomy who subsequently underwent an Indiana pouch continent urinary reservoir creation between 2012 -2018. Perioperative, intraoperative, and postoperative data were collected. The primary outcome was complication requiring readmission occurring during the first postoperative year. Secondary outcomes included rates of reoperation, pouch stones, febrile urinary tract infections, and overall mortality. RESULTS: 137 patient during the time period underwent cystectomy with Indiana pouch creation. 93% were radical cystectomies. Overall 54 (39%) patients suffered a complication during the first postoperative year. Intraoperative complications occurred in 3 (2.3%) patients. 41 (30%) of patients required readmission for various reasons including sepsis from urinary source, leak, wound infection, need for reoperation, and enterocutaneous fistula management. 15% of patients were treated for recurrent uncomplicated UTIs while 8% developed complicated UTIs requiring admission for intravenous antibiotics. Only 2 (1.5%) patients developed pouch or renal stones and 5 (3.6%) patients required stomal revisions. 23 patients (17%) required reoperation for multiple reasons including bowel perforations/leak, enterocutaneous fistula takedowns, ureteral strictures, and completion pelvic exenterations/urethrectomies. The overall one-year mortality rate for all causes was 3.7%. CONCLUSIONS: Patients undergoing cystectomy with Indiana pouch urinary reservoir creation appear to have similar complications rates overall when compared with ileal conduit or orthotopic neobladder creation. Source of Funding: NA © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e749-e749 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ryan Speir* More articles by this author Ramzy Nagle More articles by this author Hannah Jarvis More articles by this author Sean Kern More articles by this author Clint Cary More articles by this author Timothy Masterson More articles by this author Thomas Gardner More articles by this author Richard Bihrle More articles by this author Michael Koch More articles by this author Hristos Kaimakliotis More articles by this author Expand All Advertisement PDF downloadLoading ...