Page 136 - Bladder Dysfunction in the Context of the Bladder-Brain Connection - Ilse Groenendijk.pdf

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Chapter 7
ABSTRACT
Objectives: To evaluate the long-term results after the construction of a Continent
Catheterizable Urinary Conduit (CCUC) in adults.
Methods: We retrospectively reviewed the charts of 41 adults from two tertiary centers who received a CCUC. The demographics, underlying diseases, indications for a CCUC and outcomes such as the reoperation rate and the occurrence of complications were extracted. The patient reported outcome was measured with the Patient Global Impres- sion of Improvement (PGI-I) scale and four additional questions about continence, leak- age and stomal problems.
Results: Twenty-nine patients were women. The median age at surgery was 32 years with a median follow-up of 52 months. Twenty-six patients had a neurogenic bladder. The reoperation rate was 48.8% with a median of 10.5 months after constructing the CCUC. Superficial stomal stenosis was the most common registered complication (20 times) and stoma revision was the most often performed reoperation (12 times). Twenty- four patients completed the PGI-I; the mean improvement rating was 2 (= much better).
Conclusion: The construction of a CCUC in adults is associated with a high complica- tion and reoperation rate. The high reoperation rate is in accordance with the sparse literature. Despite this, patients reported “much better” on the PGI-I.
Keywords: Urinary diversion, Lower Urinary Tract Symptoms, Adults, Complications.