New Look on Ureterocolic Diversion with Adjuvant Radiotherapy; SECI (South Egypt Cancer Institute) Experience

Abstract

Background: Uret e rosigmoidostomy was the first form of continent urinary diversion and had broad popularity during the first half of the 20th century. Primary enthusiasm was followed by disappointment when serious problems such as pyelonephritis, electrolyt e imbalance, renal calculi and renal function deterioration become evident. In the 1950s these life threatening complications led to avoid this urinary diversion in favor of uretro-intestinal conduits. Objectives: Our aim was to evaluate our experience in uret e rocolic shunt after radical cystectomy for bladder cancer. Methodology: This study was conducted in surgical oncology department, South Egypt cancer institute, Assiut university; in the period from January 2012 to January 2017 and including 115 patients (75 males & 40 females). Results: This is retrospective study including 115 patients (75 males & 40 females). Operative time was 130 minutes ranging between 2 to 2.5 hours. Average blood loss was 450 ml. After removal of rectal tube all patients were continent except 15 patients who were improved after 1 - 3 days. Within a month 12 patients had night incontinence and 5 patients had day time incontinence. After that day and night continence gradually improved in all patients except two females who had persistent night soiling and was in need for night time rectal tube. Conclusion: Uret e rosigmoidostomy regains the interest of surgical oncology and urologist because of its simplicity and absence of appliance as many patients refusing cutaneous stoma and others are not suitable for orthotopic substitutes.