THE ROLE OF INTERVENTIONAL RADIOLOGY IN THE MANAGEMENT OF INTRA-PERITONEAL AND EXTRA-PERITONEAL LEAKAGE IN PATIENTS WHO HAVE UNDERGONE CONTINENT URINARY-DIVERSION

Purpose: To assess how radiologic intervention altered the hospital co urse of patients undergoing continent urinary diversion. Methods: Thir ty-seven consecutive patients with bladder cancer invading the muscula r layer were treated with total cystectomy and construction of a conti nent urinary reservoir. Eleven of 37 patients suffered early and late anastomotic leakage; six had prolonged extraperitoneal leakage at the urethroenteric anastomosis, three had prolonged intraperitoneal pouch leaks, and two had delayed ureteroenteric leaks, Seven of these patien ts required radiologic intervention. Results: Intervention in the form of drainage catheter manipulation (n = 4), percutaneous nephrostomy ( n = 4), or ureteral stent placement (n = 2) resulted in cessation of l eakage without surgical intervention in all seven patients, Intraperit oneal pouch leaks were more difficult to control than extraperitoneal leakage and required longer drainage intervals. Conclusion: Interventi onal radiologic procedures played a key role in the management of cont inent urinary diversion complications, obviating the need for repeat s urgical intervention in all instances.