Patient Selection and Outcomes of Urinary Diversion.

Kevin J Hebert, Rano Matta, Jeremy B Myers

Journal: The Urologic clinics of North America 2022;49(3):533-551

PMID: 35931442

Full Text on Elsevier Science View on PubMed

Abstract

Urinary diversion selection depends highly on surgeon experience, patient comorbidities, operative indication, and preoperative risk assessment. Navigating this process in the setting of emerging surgical approaches, new operative technology, and evolving perioperative care plans can be difficult for general and reconstructive urologists alike. In this article, we highlight considerations for urinary diversion selection and review new updates in the literature regarding preoperative patient assessment and nutrition optimization. In addition, we review unique perioperative considerations including role of preoperative bowel prep and intraoperative maneuvers in the setting of obesity and prior radiation. Last, we examine postoperative expectations, long-term outcomes, and emerging technology to mitigate postoperative risk associated with urinary diversions.

Address: Genitourinary Injury and Reconstructive Urology, Department of Surgery (Urology), University of Utah, 30 North 1900 East, Room # 3B420, Salt Lake City, UT 84132, USA.; Genitourinary Injury and Reconstructive Urology, Department of Surgery (Urology), University of Utah, 30 North 1900 East, Room # 3B420, Salt Lake City, UT 84132, USA. Electronic address: [email protected].

DOI: 10.1016/j.ucl.2022.04.011

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MeSH Terms: Cystectomy, Humans, Patient Selection, Postoperative Complications, Urinary Bladder Neoplasms, Urinary Diversion