Hypothesis / aims of study
After urinary diversion with ileal conduit for benign indications, most patients are left with a defunctionalised remnant bladder. It is recognised that pyocystis is a common complication in this setting but can be difficult to treat. In our patient cohort undergoing ileal conduit diversion for benign aetiology we sought to assess the incidence and risk factors for pyocystis and evaluated the management of pyocystis at our institution and requirement for subsequent remnant bladder cystectomy.
Study design, materials and methods
A retrospective review was performed of all patients at our institution undergoing urinary diversion with ileal conduit (benign causes) over a 9 year period (1997-2004). Data sets collected included demographics, co-morbidities, indication for diversion, incidence of post-operative pyocystis and management of pyocystis and requirement for subsequent remnant bladder cystectomy. Statistical analysis was performed to assess if any patient factors were associated with the development of pyocystis or requirement for subsequent cystectomy.
Interpretation of results
There were no patient factors identified as having a statistically significant association with pyocystis development but both male gender and pre-diversion suprapubic catheterisation show a trend towards being associated with pyocystis.
95% of patients with pyocystis required eventual remnant bladder cystectomy and the association is statistically significant (p<0.01). Indeed the only patient with pyocystis not undergoing cystectomy was due to lack of medical fitness for further general anaesthetic.