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Long-term effects of ileal conduit urinary diversion on upper urinary tract in bladder cancer

 Won Jae Yang  ;  Kang Su Cho  ;  Koon Ho Rha  ;  Hye Young Lee  ;  Byung Ha Chung  ;  Sung Joon Hong  ;  Seung Choul Yang  ;  Young Deuk Choi 
 UROLOGY, Vol.68(2) : 324-327, 2006 
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Adult ; Aged ; Aged, 80 and over ; Cystectomy*/adverse effects ; Female ; Follow-Up Studies ; Humans ; Ileum/surgery ; Kidney/pathology* ; Kidney/physiopathology* ; Male ; Middle Aged ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Time Factors ; Ureter/pathology* ; Ureter/physiopathology* ; Urinary Bladder Neoplasms/surgery* ; Urinary Diversion*/adverse effects ; Urinary Diversion*/methods
OBJECTIVES: To evaluate the functional and morphologic changes of the upper urinary tract after radical cystectomy and ileal conduit urinary diversion for bladder cancer.
METHODS: Radical cystectomy and ileal conduit urinary diversion were performed in a total of 249 patients with bladder cancer at our hospital from 1980 to 1999. Of the 249 patients, 67 were excluded because of the presence of preoperative lesions in the upper urinary tract or elevated serum creatinine (greater than 1.4 mg/dL). Of the remaining 182 patients, 82 were also excluded because of incomplete follow-up or death less than 5 years after surgery.
RESULTS: Of the 249 patients, a total of 100 (40.2%) who had no preoperative lesions in upper urinary tract and normal renal function and survived 5 years or longer were included in this analysis. The median follow-up period was 91 months (range 60 to 193). The serum creatinine was greater than the normal range in 10 patients (10.0%), and radiologic changes in the upper urinary tract were observed in 14 patients (14.0%). They had diabetes mellitus nephropathy (4.0%) or specific comorbidities that could contribute to the deterioration of the upper urinary tract, such as ureteroileal anastomotic stricture (4.0%), chronic pyelonephritis (4.0%), urinary stones (1.0%), and upper urinary tract tumor (1.0%).
CONCLUSIONS: The results of our study have shown that the functional and morphologic changes in the upper urinary tract after radical cystectomy and ileal conduit urinary diversion occur in patients with specific comorbidities that could contribute to those changes. Different from previous reports, none of the upper urinary tract changes developed without an obvious cause.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
Yang, Seung Choul(양승철)
Chung, Byung Ha(정병하) ORCID logo https://orcid.org/0000-0001-9817-3660
Cho, Kang Su(조강수) ORCID logo https://orcid.org/0000-0002-3500-8833
Choi, Young Deuk(최영득) ORCID logo https://orcid.org/0000-0002-8545-5797
Hong, Sung Joon(홍성준) ORCID logo https://orcid.org/0000-0001-9869-065X
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