Ileal conduit post radical cystectomy: modifications of the technique.

INTRODUCTION

Ileal conduit, post radical cystectomy, is currently the most practiced type of urinary diversion. The aim of our study was to modify the ileal conduit technique in order to retain acceptable outcomes while decreasing the rate of postoperative urine leak and ureteroileal stricture.

METHODS

Forty consecutive patients were included in our study, from January to June 2011. Radical cystectomy and ileal conduit using our modifications were done for all the cases. Follow-up was done for one year. One patient with right pelvic kidney was added to the studied group and was managed by extra modification to our technique.

RESULTS

The mean age of the patients was 63 years. No significant leak and no stricture were observed within the modest duration of follow-up. When a left upper urinary tract retrograde study was attempted in one patient, the left ureteric orifice could not be reached due to a redundant elongated ileum.

CONCLUSIONS

Modified Bricker techniques are safe, avoid early postoperative urine leak, and lower the incidence of ureteroileal anastomotic stricture. Using our modifications, retrograde access of the left ureter may not be possible. The 'Z' ileal conduit is a feasible technique that can allow tension-free healthy ureteroileal anastomosis for cases with pelvic right kidney and, probably, post renal transplantation.