Long-term outcome of incontinent ileovesicostomy management of severe lower urinary tract dysfunction

Purpose: We evaluated the extended S-year followup outcome of incontinent i leovesicostomy. Materials and Methods: We reviewed the charts of 25 men and 13 women with a mean age of 44.9 years who underwent incontinent ileovesicostomy, includin g the original 23 patients whom we reported on in 1993. Mean followup was 5 2 months. We compared the incidence of complications before and after ileov esicostomy as well as long-term urinary tract status. Results: Before ileovesicostomy the incidence of serious complications asso ciated with an indwelling catheter was significant, including poor bladder compliance in 50% of cases, urosepsis in 45%, hydronephrosis in 21%, renal struvite calculi in 18%, urethrocutaneous fistula in 18%, autonomic dysrefl exia in 13% and bladder calculi in 2%. After conversion to ileovesicostomy our data show that 83 to 91% of this high risk population maintained a norm al upper urinary tract and normal bladder storage compliance. Conclusions: Compared with preoperative status the incidence of postoperati ve complications was relatively low and they were readily corrected. Ileove sicostomy is an excellent long-term management solution for severe lower ur inary tract dysfunction in patients who are unable to perform intermittent self-catheterization.