The following is a summary of “Cutaneous Ureterostomy Following Radical Cystectomy for Bladder Cancer: A Contemporary Series,” published in the November 2023 issue of Urology by Nabavizadeh, et al.

For a study, researchers sought to present the peri-operative outcomes of a contemporary cohort of bladder cancer patients who underwent radical cystectomy (RC) with cutaneous ureterostomy (CU) urinary diversion at a tertiary referral center.

Patients who underwent RC with CU at Mayo Clinic between 2016 and 2021 were retrospectively identified. Clinicopathologic and perioperative characteristics were analyzed using standard descriptive statistics.

A total of 31 patients underwent RC with CU at our institution, with a median age of 72 years, and 21 were male. The cohort exhibited a high level of comorbidity, with 83% having an American Society of Anesthesiologists (ASA) Physical Status Classification System ≥3 and a median Charlson Comorbidity index of 8. Median time to flatus, tolerating a regular diet, and length of stay were 3 days (interquartile range [IQR] 3-3), 3 days (IQR 3-4), and 4 days (IQR 4-7), respectively. Within 30 days of surgery, 14 patients experienced a high-grade complication (Clavien-Dindo ≥3), and 8 were readmitted. Sepsis was the most common 30-day complication, affecting 13% of patients (4/31). At 90 days post-surgery, the readmission rate was 32% (10/31), predominantly for sepsis. Three patients required reoperation within 90 days, one of whom needed CU revision due to stomal ischemia. One patient died within this timeframe from causes unrelated to bladder cancer.

In a comorbid, relatively elderly bladder cancer cohort undergoing RC, CU utilization was associated with swift surgery and postoperative recovery. CU represents a viable option for urinary diversion in high-risk patients undergoing RC. The increased incidence of postoperative ureteral obstruction can be proactively managed with chronic stent placement.

Reference: goldjournal.net/article/S0090-4295(23)00733-1/fulltext