Eigner E B, Freiha F S
Division of Urology, Stanford University, California.
J Urol. 1990 Jul;144(1):31-3. doi: 10.1016/s0022-5347(17)39358-8.
A retrospective study of 30 adults who underwent supravesical diversion for a variety of benign and malignant conditions was done with special attention to the fate of the residual bladder. Diversion was performed for diverse conditions, including radiation cystitis, cyclophosphamide cystitis, interstitial cystitis, incontinence and trauma. All groups experienced significant morbidity from the remaining in situ bladder. Over-all, 80% of the patients experienced at least 1 complication, chief among which were pyocystis (67%), hemorrhage (23%), severe pain (13%), and unremitting feelings of incomplete emptying and spasm (17%). Complications of sufficient severity to require rehospitalization occurred in 43% of the patients. Several patients required multiple rehospitalizations. Reoperation requiring general or regional anesthesia was necessary in 9 patients (30%) and included 4 cystectomies. Serious consideration should be given to performing primary cystectomy at the time of supravesical diversion in any patient in whom subsequent undiversion is not anticipated.
对30例因各种良性和恶性疾病接受膀胱上尿路改道的成年人进行了一项回顾性研究，特别关注残余膀胱的转归。改道手术针对多种疾病进行，包括放射性膀胱炎、环磷酰胺性膀胱炎、间质性膀胱炎、尿失禁和创伤。所有组均因残余原位膀胱而出现显著的发病率。总体而言，80%的患者至少经历了1种并发症，其中主要有膀胱积脓（67%）、出血（23%）、严重疼痛（13%）以及持续的排空不全和痉挛感（17%）。43%的患者出现了严重到需要再次住院的并发症。有几位患者需要多次再次住院。9例患者（30%）需要进行需要全身或区域麻醉的再次手术，其中包括4例膀胱切除术。对于任何预计不会进行后续去转流手术的患者，在进行膀胱上尿路改道时应认真考虑同时进行一期膀胱切除术。
