Abstract
Supravesical urinary diversion without cystectomy is a common procedure performed to manage a variety of lower urinary tract pathologies. The purpose of this article is to review the complications associated with the bladder left in situ and to relate this to the female patient. Complications related to the defunctionalized bladder include pyocystis, hemorrhage, pain/spasm and neoplastic transformation. The defunctionalized bladder also has implications for sexual function, pregnancy and undiversion. The risk factors for complications are chronic infection, inadequate drain-age, interstitial cystitis and previous irradiation. The incidence of neoplastic change in the defunctionalized bladder is low, but long-term follow-up is advised, as carcinoma could develop many decades after diversion. Sexual function following urinary diversion is better preserved when the bladder is retained.
Similar content being viewed by others
References
Adeyoju AB, Lynch T, Thornhill J. et al. The fate of the defunctioned bladder following supra-vesical urinary diversion.Br J Urol 1996;78:80–83
Chun AL, Ruzich JV, Wein AJ, Levin RM. Functional and pharamacological effects of urethral diversion.J Urol 1989;141:403–407
Jayanthi VR, McLorie GA, Khoury AE, Churchill BM. The effect of temporary cutaneous diversion on ultimate bladder function.J Urol 1995;54:889–892
Engel RM. Complication of bilateral uretero-ileocutaneous urinary diversion: a review of 208 cases.J Urol 1969;101:508–512
Eigner EB, Freiha FS. The fate of the remaining bladder following supravesical diversion.J Urol 1990;144:31–33
Retik AB, Perlmutter AD, Gross RE. Cutaneous ureteroileostomy in children.N Engl J Meal 1967;277:217–222
Guerrier K, Albert DJ, Persky L. Experiences with pyocystis.Arch Surg 1971;103:63–65
Dretlar SP. The occurrence of empyema cystis: management of the bladder left behind.J Urol 1972;108:82–84.
Spence HM, Allen TD. Vaginal vesicotomy for empyema of the defunctionalized bladder.J Urol 1971;106:862–864
Polsky MS, Weber CH Jr., Williams JE, Nikolewski RF, Barr MT, Ball TP. Chronically infected and post-diversionary bladders: cytologic and histopathologic study.Urology 1976;7:531–535
Garvin DD, Weber CH Jr, Polsky MS. Carcinoma in the defunctionalized bladder: report of a case and review of the literature.J Urol 1977;117:669
Djavan B, Litwiller SE, Milchgrub S, Roehrborn CG. Mucinous adenocarcinoma in defunctionalized bladders.Urology 1995;46:107–110.
Kolodny RC, Textbook of human sexuality for nurses. Boston: Little Brown, 1979; p 169
Levin RJ. The physiology of sexual function in women.Clin Obstet Gynecol 1980;7:207–212
Nordstrom GM, Nyman CR. Male and female sexual function and activity following ileal conduit urinary diversion.Br J Urol 1992;70:33–39
Malone PR, Stanton SL, Riddle PR. Urinary diversion for incontinence — a beneficial procedure.Ann Roy Coll Surg Engl 1985;67:349–352
Desmond AD, Shuttleworth KED. The results of urinary diversion in multiple sclerosis.Br J Urol 1977;49:495–502
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Adeyoju, A.B., Lynch, T.H. & Thornhill, J.A. The defunctionalized bladder. Int Urogynecol J 9, 48–51 (1998). https://doi.org/10.1007/BF01900542
Issue Date:
DOI: https://doi.org/10.1007/BF01900542