Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Feb;25(1):125-131.
doi: 10.1007/s10029-020-02230-6. Epub 2020 Jun 3.

The European Hernia Society classification applied to the rare cases of parastomal hernia after ileal conduit urinary diversion: a retrospective cohort of 96 patients

J S Su  1 , N Y Hoy  2 , A Fafaj  3 , L Tastaldi  3 , A Strong  3 , M Rosen  3 , J Li  4 , H M Wood  2
Affiliations

The European Hernia Society classification applied to the rare cases of parastomal hernia after ileal conduit urinary diversion: a retrospective cohort of 96 patients

J S Su et al. Hernia. 2021 Feb.

Abstract

Introduction: To determine the incidence and classification of parastomal hernia (PH) following ileal conduit urinary diversion and to identify risk factors for PH development.

Methods: We performed a retrospective review of our cystectomy database which includes benign and malignant cases from 2011-2016. Patients with an abdominal CT at 24 ± 2 months post-operation were included. PH were classified according to the European Hernia Society (EHS) system. Regression analyses were performed on variables associated with parastomal hernia.

Results: A total of 96 patients were included in the study. The incidence of PH on CT is 20.2% at one year and 28.1% at two years. Using the EHS classification, the majority of PH was small (≤ 5 cm), but up to 50% were associated with a concomitant incisional hernia. On multivariable analysis, (C-index = 0.71), obesity was associated with a higher risk of PH (OR = 2.8, 95% CI 1.06-7.42, p = 0.04), whereas prior tobacco use was associated with a lower risk of PH at 2 years (OR = 0.23, 95% CI 0.09-0.63, p < 0.01).

Conclusions: Hernia after ileal conduit is common with radiographic rates approaching 30% at two years, with obesity being an independent risk factor. The relationship between prior tobacco use and a lower hernia rate may be limited to this study but presents an opportunity for future investigation. No difference in PH rates were observed between open and minimally invasive surgery and between intracorporeal and extracorporeal conduits.

Keywords: European Hernia Society; Ileal conduit; Parastomal hernia; Urinary diversion.

PubMed Disclaimer

Comment in

References

    1. Farnham SB, Cookson MS (2004) Surgical complications of urinary diversion. World J Urol 22:157–167. https://doi.org/10.1007/s00345-004-0429-5 - DOI - PubMed
    1. Gore JL, Litwin MS (2009) Quality of care in bladder cancer: trends in urinary diversion following radical cystectomy. World J Urol 27:45–50. https://doi.org/10.1007/s00345-008-0348-y - DOI - PubMed
    1. Kouba E, Sands M, Lentz A et al (2007) Incidence and risk factors of stomal complications in patients undergoing cystectomy with ileal conduit urinary diversion for bladder cancer. J Urol 178:950–954. https://doi.org/10.1016/j.juro.2007.05.028 - DOI - PubMed
    1. Gerharz EW, Månsson Å, Hunt S et al (2005) Quality of life after cystectomy and urinary diversion: an evidence based analysis. J Urol 174:1729–1736. https://doi.org/10.1097/01.ju.0000176463.40530.05 - DOI - PubMed
    1. Donahue TF, Cha EK, Bochner BH (2016) Rationale and early experience with prophylactic placement of mesh to prevent parastomal hernia formation after ileal conduit urinary diversion and cystectomy for bladder cancer. Curr Urol Rep 17:9. https://doi.org/10.1007/s11934-015-0565-z - DOI - PubMed - PMC

LinkOut - more resources