Current practice and controversies in urinary diversion--the selection of the operation method of urinary diversion and postoperative care

摘要

Since Kock et al. reported a low pressure continent reservoir using detubularized ileal segment as urinary diversion following cystectomy, continent urinary diversion including neobladder has been focused upon. On the other hand, ureterocutaneostomy, or ileal conduit as an incontinent urinary diversion is still commonly used, and especially the latter form is usually performed in many hospitals. These facts suggest that it is difficult to conclude that continent urinary diversion regarded as an excellent operation with good quality of life (QOL) is a generally acceptable method and that there are still some problems to decide the indication for urinary diversion. We discuss the problems about the postoperative complications and care of urinary diversion after cystectomy and our opinion about the selection of these operations.