Presentation Authors: Kai Wen Cheng*, Ankeet Shah, Gus Miranda, Anne Schuckman, Siamak Daneshmand, Hooman Djaladat, Los Angeles, CA
Introduction: Limited outcome studies exist for subtypes of continent cutaneous urinary diversions (CCUD). This study evaluates two subtypes of CCUD; Indiana Pouch (IP) and Appendico-umbilicostomy (AU), by investigating diversion-specific complications and quality of life after diversion.
Methods: A retrospective review of an IRB-approved database was conducted for perioperative and outcome data. The EORTC QLQ-C30 questionnaire was used to assess quality of life; all responses were dated >6 months after diversion.
Results: 58 patients (33 IP under 2 surgeons, 25 AU under 1 surgeon) were identified for this study (2010-2016). All 3 surgeons were fellowship-trained urologic oncologists. Patient characteristics are summarized in Table 1. Higher age and higher Charlson Comorbidity Index (CCI) â‰¥3 were seen in the AU cohort (p=0.002, 0.006, respectively). Outcome data are listed in Table 2. After a median follow up of 21 months (range:0.8-81.0), more stoma complications were reported for the AU cohort (p=0.049). In both types of diversions, >60% of stoma complications occurred at skin/fascia level. In the 90-day postoperative period, a higher continence rate was reported for the IP cohort (p=0.017). 24 responses were recorded for the EORTC questionnaire (14 IP, 10 AU): for both cohorts >70% of patients reported little to no disturbance of daily functions and rated overall quality of life as â‰¥70% (Table 3).
Conclusions: The Indiana Pouch and Appendico-umbilicostomy urinary diversions are associated with high rates of continence and patient satisfaction. Stoma complications are common and are mostly seen at superficial level. Our Appendico-umbilicostomy cohort had a higher rate of stoma complication and a lower 90-day continence rate; however, this may be attributed to higher age and CCI in this cohort.