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
. 2022 Sep;130(3):381-388.
doi: 10.1111/bju.15658. Epub 2021 Dec 6.

Risk factors and natural history of parastomal hernia after radical cystectomy and ileal conduit

Alireza Ghoreifi  1 , Evan Allgood  2 , Gilbert Whang  2 , Antoin Douglawi  1 , Wenhao Yu  1 , Jie Cai  1 , Gus Miranda  1 , Monish Aron  1 , Anne Schuckman  1 , Mihir Desai  1 , Inderbir Gill  1 , Siamak Daneshmand  1 , Vinay Duddalwar  2 , Hooman Djaladat  1
Affiliations

Risk factors and natural history of parastomal hernia after radical cystectomy and ileal conduit

Alireza Ghoreifi et al. BJU Int. 2022 Sep.

Abstract

Objective: To investigate the incidence, risk factors and natural history of parastomal hernia (PSH).

Materials and methods: We reviewed the records of patients who underwent radical cystectomy (RC) and ileal conduit (IC) procedure between 2007 and 2020. Patients who had available follow-up computed tomography (CT) imaging were included in this study. All CT scans were re-reviewed for detection of PSH according to Moreno-Matias classification. Patients who developed hernia were followed up and classified into stable or progressive (defined as radiological upgrading and/or need for surgical intervention) groups. Multivariable Cox regression was performed to identify independent predictors of hernia development and progression.

Results: A total of 361 patients were included in this study. The incidence of radiological PSH was 30%, graded as I (56.5%), II (12%) and III (31.5%). The median (interquartile range [IQR]) time to radiological hernia was 8 (5-15) months. During the median (IQR) follow-up of 27 (13-47) months in 108 patients with a hernia, 26% patients progressed. The median (IQR) time to progression was 12 (6-21) months. On multivariable analysis, female gender (hazard ratio [HR] 1.86), diabetes (HR 1.81), chronic obstructive pulmonary disease (COPD; HR 1.78) and higher body mass index (BMI; HR 1.07 for each unit) were independent predictors for radiological PSH development. No significant factor was found to be associated with hernia progression.

Conclusion: Radiological PSH after RC and IC occurred in 30% of patients, a quarter of whom progressed in a median time of 12 months. Female gender, diabetes, COPD and high BMI were independent predictors for radiological hernia development.

Keywords: #Urology; #uroonc; cystectomy; hernia; natural history; risk factors; urinary diversion.

PubMed Disclaimer

Comment in

References

    1. Chang SS, Bochner BH, Chou R et al. Treatment of non-metastatic muscle-invasive bladder cancer: AUA/ASCO/ASTRO/SUO Guideline. J Urol 2017; 198: 552-9
    1. Hautmann RE, Abol-Enein H, Hafez K et al. Urinary diversion. Urology 2007; 69: 17-49
    1. Farnham SB, Cookson MS. Surgical complications of urinary diversion. World J Urol 2004; 22: 157-67
    1. Madersbacher S, Schmidt J, Eberle JM et al. Long-term outcome of ileal conduit diversion. J Urol 2003; 169: 985-90
    1. Donahue TF, Bochner BH, Sfakianos JP et al. Risk factors for the development of parastomal hernia after radical cystectomy. J Urol 2014; 191: 1708-13

LinkOut - more resources