JCU - Abstracts of the BAUS 2018 Scientific Meeting - June 2018 - 90

Journal of Clinical Urology 11(1S)

32.3% had continued pain following surgery: 28.6% (2) had
undergone subtotal cystectomy & ileocystoplasty, 30.4%
(7) total cystectomy & ileal conduit and 50% (2) total cystectomy & neobladder formation.
Conclusion: Reconstructive surgery can result in resolution of BPS/IC symptoms but should be considered a last
resort due to the potential morbidity and risk of persistent symptoms in just over a third of patients. There is a
need to identify preoperative factors that may predict a
poor outcome.
P10-14 Is obstruction of ileal conduit after
parastomal hernia repair with porcine
derived tissue matrix Strattice™ a valid
concern?
Kotes S1, Greenwell T, Wood D, Ockrim J
1UCLH, London, United Kingdom

Introduction and Objective: Parastomal hernia occurs
in 17% of patients with ileal conduit and recurrence following repair occurs in 27-50%. The introduction of the
porcine derived tissue matrix Strattice™ showed promising results in colorectal practice. We have reviewed repair
of ileal conduit para-stomal hernias to compare outcomes
in urological practice.
Methods: We retrospectively reviewed notes of 57
patients (18 men) of mean age 56 years (range 33-78) with
ileal conduits having repair of hernia with Strattice™
mesh. Data collected included type of hernia repair (incisional or parastomal) and possible mesh related complications.All repairs were performed by 4 consultant surgeons
utilising conduit pull through and intra-peritoneal lateral
mesh fixation to the anterior abdominal wall.
Results: Of the 57 patients included, 34 had incisional hernia repair (mean age 60 years, range 41-77, 9 men) and 23
had para-conduit stoma hernia repair (mean age 54 years,
range 33-71, 6 men). Complications are detailed in table 1.
Conclusion: 9 (39%) of 23 patients having repair of their
ileal conduit parastomal hernia with Strattice™ mesh
developed obstructive complications whilst the parastomal hernia recurred in only 6/23 (26%). The rate of
obstructive complications is higher than expected and
warrants further close follow-up and study in prospective
series. It may be that success in para-stomal repair is at the
expense of obstructive complications.
P10-14: Table 1
Complication

Number

Conduit obstruction at level of mesh
Stomal retraction with shortening
and subsequent obstruction
Recurrence of parastromal hernia
Seroma

7
2

30
9

6
1

26
4

P10-15 The incidence of pyocystis following
ileal conduit urinary diversion for benign
aetiology and subsequent requirement for
remnant bladder cystectomy
Mankaryous G2, Barratt R1, Pakzad M2, Hamid R2,
Ockrim J2, Greenwell T2
1Whipps Cross Hospital, London, United Kingdom, 2University
College London Hospital, United Kingdom

Introduction: Pyocystis of a remnant bladder following
ileal conduit urinary diversion can be difficult to treat conservatively and often requires remnant bladder cystectomy. We sought to assess the incidence, risk factors and
need for subsequent cystectomy in patients with pyocystis
of defunctionalised bladders following ileal conduit urinary
diversion for benign causes.
Patients and Methods: Patients undergoing ileal conduit urinary diversion (benign aetiology) over a 17 year
period (1997-2004) were identified and records analysed.
Data retrieved included patient demographics and comorbidities, indications for urinary diversion, development
and treatment of pyocystis and the need for subsequent
cystectomy. Mean age was 46 years (range 2-78) and mean
follow-up 49 months (range 6-252 months).
Results: 66 (81%) female and 15 (19%) male patients
were included in the analysis. Indications for conduit formation included: end-stage complex urinary incontinence, bladder pain syndrome, atonic bladder and
Fowler's syndrome. Treatment options utilised for
patients with pyocystis included: antibiotics, remnant
bladder intermittent self-catheterisation, remnant bladder washout and simple cystectomy. Risk factors for pyocystis and the incidence of cystectomy are detailed in
Table 1. 18 patients with pyocystis (95%, p<0.01) required
eventual cystectomy. The remaining patient with pyocystis was not medically fit for further surgery. There were
no correlations between aetiology and subsequent
development of pyocystis.
Conclusion: Following ileal conduit diversion for benign
aetiology 24% of patients developed pyocystis. Conservative

P10-15: Table 1.

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