Margit Fisch, MD, FEAPU, FEBU, presented “Ureterocutaneostomy: A Valuable Option for Urinary Diversion in the Elderly Patient?” during the 40th Annual Ralph E. Hopkins Urology Seminar on February 5th, 2020 in Jackson Hole, Wyoming.
How to cite: Fisch, Margit. “Ureterocutaneostomy: A Valuable Option for Urinary Diversion in the Elderly Patient?” February 5th, 2020. Accessed Sep 2020. https://grandroundsinurology.com/ureterocutaneostomy-a-valuable-option-for-urinary-diversion-in-the-elderly-patient/
Ureterocutaneostomy: A Valuable Option for Urinary Diversion in the Elderly Patient? – Summary:
Margit Fisch, MD, FEAPU, FEBU, Director and Chair of the Department of Urology and Pediatric Urology at University Medical Center Hamburg-Eppendorf in Hamburg, Germany, discusses the value of ureterocutaneostomy as a urinary diversion technique for the increasing number of older, sicker patients with urothelial carcinoma of the bladder. Dr. Fisch explains that, compared with other urinary diversions, ureterocutaneostomy is a simpler, shorter procedure with no significant quality of life differences. She then summarizes the findings of a cystectomy series, which showed that even though patients who had undergone ureterocutaneostomy were older, more likely to have comorbidities, and more likely to have had prior pelvic/abdominal surgeries and irradiation compared with patients who had received ilial/colonic conduit or continent diversion, they had the shortest surgeries and hospital stays during cystectomy, as well as no difference in 30-day complication rate. The benefits of ureterocutaneostomy are further corroborated by a study which compared ureterocutaneostomy to urinary diversion with use of bowel, and found that ureterocutaneostomy patients had shorter operating room time, shorter time in the ICU, and fewer serious complications, although they did experience higher long-term morbidity, probably because of comorbidities. Dr. Fisch notes that ureterocutaneostomy has late complications such as abscess formation, ureteral necrosis, stoma stenosis, and pyelonephritis, but concludes that conduits are no better in this area, and that the benefits of ureterocutaneostomy make it a valuable and useful diversion in elderly patients.
About The 40th Annual Ralph E. Hopkins Urology Seminar:
The Ralph E. Hopkins Urology Seminar is a multi-day meeting focused on training urologists in the latest in assessing, diagnosing, and treating urologic conditions in the clinical setting. Updates are provided on urologic cancers, stone disease, urologic reconstruction, female urology, infertility, emerging surgical techniques, and general urology. Dr. Fisch presented this lecture during the 40th iteration of the meeting on February 5th, 2020 in Jackson Hole, Wyoming.
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