Tumors following urinary diversions. Results of a multicenter study

Kälble T, Hofmann I

Der Urologe. Ausg. A, 2011

Abstract

BACKGROUND: The risk estimation of secondary tumors after different types of urinary diversion with intestinal segments has as yet been possible only for ureterosigmoidostomy.

METHOD: We analyzed the operative records of 44 German clinics for urinary diversions performed from 1970 to 2007 and registered all reported secondary tumors up to 2009.

RESULTS: In 17,758 urinary diversions 32 secondary tumors occurred. The tumor risk in ureterosigmoidostomy (2.58%) and cystoplasty (1.58%) is significantly higher than in other continent forms of urinary diversion (p<0.0001). The risk in orthotopic (ileo)colonic neobladders (1.29%) is significantly higher (p=0.0001) than in ileal neobladders (0.05%). The difference between ileocecal pouches (0.14%) and ileal neobladders is not significant (p=0.46).

CONCLUSION: Ureterosigmoidostomies, cystoplasties, and orthotopic (ileo)colonic neobladders necessitate regular endoscopic evaluation from at least the fifth postoperative year. After ileal neobladders, conduits, and catheterizable ileocecal pouches regular routine endoscopy is not imperative.

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