New Look on Ureterocolic Diversion with Adjuvant Radiotherapy; SECI (South Egypt Cancer Institute) Experience

Background: Ureterosigmoidostomywas the first form of continent urinary diversion and had broad popularityduring the first half of the 20th century. Primary enthusiasm was followed by disappointmentwhen serious problems such as pyelonephritis, electrolyte imbalance, renal calculiand renal function deterioration become evident. In the 1950s these lifethreatening complications led to avoid this urinary diversion in favor ofuretro-intestinal conduits. Objectives: Our aim was to evaluate our experience in ureterocolic shunt afterradical cystectomy for bladder cancer. Methodology: This study wasconducted in surgical oncology department, South Egypt cancer institute, Assiutuniversity; in the period from January 2012 to January 2017 and including 115patients (75 males u0026 40 females). Results: Thisis retrospective study including 115 patients (75 males u0026 40 females).Operative time was 130 minutes ranging between 2 to 2.5 hours. Average bloodloss was 450 ml. After removal of rectal tube all patients were continentexcept 15 patients who were improved after 1 - 3 days.Within a month 12 patients had night incontinence and 5 patients had day timeincontinence. After that day and night continence gradually improved in allpatients except two females who had persistent night soiling and was in needfor night time rectal tube. Conclusion: Ureterosigmoidostomy regains the interest of surgicaloncology and urologist because of its simplicity and absence of appliance asmany patients refusing cutaneous stoma and others are not suitable fororthotopic substitutes.