Technique of Suprafascial Anastomosis With Reduced Risk of Stenosis of the Efferent Outlet in Continent Catheterizable Urinary Diversion.

OBJECTIVE: To describe our technique and long-term experience with a technique of a suprafascial anastomosis for the efferent continent segment in continent cutaneous urinary diversion, which aims to reduce the rate of stomal strictures.

MATERIALS AND METHODS: Between 1998 and 2013, up to 191 patients underwent continent cutaneous urinary diversion with a suprafascial anastomosis technique at our institution. A complete follow-up was achievable in 82 patients. The retrospective analysis included continence rates, stomal complications, and other complications related to the urinary diversion such as anastomotic insufficiencies, fistulas, or hernias.

RESULTS: The study population consisted of 82 patients with 67 (82%) women and 15 (18%) men with a median age of 58 years. The median length of follow-up was 82 months (range 13-203) with a median survival time of 46 (range 13-193) months. At the time of the analysis, 46 patients (57%) were still alive. Five out of 82 patients (6%) presented with a relevant stenosis in umbilical stoma that required surgical revisions. Nine patients (12%) with functional stenosis could be treated conservatively. Continence was achieved in 74 of 82 patients (90%). Only 8 patients reported some degree of incontinence.

CONCLUSION: The technique of a suprafascial stoma is a simple and safe technique that may help prevent the incidence of stomal complications.