Open AccessComplications of Ileal Conduits after Radical Cystectomy: Interventional Radiologic Management
Author(s) -
Katsuhiro Kobayashi,
Atin Goel,
Marlon Coelho,
Mariangeles Medina Perez,
Matthew Klumpp,
Sanjit Tewari,
Tomas Appleton-Figueira,
David J. Pinter,
Oleg Shapiro,
Mohammed Jawed
Publication year - 2021
Publication title -
radiographics
Language(s) - English
Resource type - Journals
eISSN - 1527-1323
pISSN - 0271-5333
DOI - 10.1148/rg.2021200067
Subject(s) - medicine , cystectomy , urinary diversion , urinoma , surgery , fistula , anastomosis , stenosis , lymphocele , electrical conduit , urinary system , radiology , complication , bladder cancer , mechanical engineering , cancer , engineering
Since their introduction into clinical practice in the 1950s, ileal conduits have been the most common type of urinary diversion used after radical cystectomy worldwide. Although ileal conduits are technically simpler to construct than other forms of urinary diversion, a variety of complications can occur in the early and late postoperative periods. Early complications include urine leakage, urinary obstruction, postoperative fluid collection (eg, urinoma, hematoma, lymphocele, or abscess), and fistula formation. Late complications include ureteroileal anastomotic stricture, stomal stenosis, conduit stenosis, and urolithiasis. Although not directly related to ileal conduits, ureteroarterial fistula can occur in patients with an ileal conduit. Interventional radiologists can play a pivotal role in diagnosis and management of these complications by performing image-guided minimally invasive procedures. In this article, the authors review the surgical anatomy of an ileal conduit and the underlying pathophysiology of and diagnostic workup for complications related to ileal conduits. The authors also discuss and illustrate current approaches to interventional radiologic management of these complications, with emphasis on a collaborative approach with urologists or endourologists to best preserve patients' renal function and maintain their quality of life. © RSNA, 2020.