Presentation Authors: Philip Cheng*, Sorena Keihani, Salt Lake City, UT, Sanchita Bose, Rose Khavari, Houston, TX, Sean Elliott, Joseph Pariser, Joshua Roth, Minneapolis, MN, Blayne Welk, London, Canada, Michael Kennelly, Cameron Futral, Chapel Hill, NC, David Ginsberg, Los Angeles, CA, Christopher Elliott, San Jose, CA, Kyla Valaer, Palo Alto, CA, Sara Lenherr, Salt Lake City, UT, Yahir Santiago-Lastra, San Diego, CA, John Stoffel, Ann Arbor, MI, Jeremy Myers, Salt Lake City, UT
Introduction: In cutaneous catheterizable ileocecocystoplasty (CCIC), the bladder is augmented with cecum and ascending colon and the catheterizable channel is created using tapered terminal ileum and plication of the ileocecal valve, while in ileocystoplasty (IC) small bowel is used for augmentation and a catheterizable channel made of small bowel, large bowel, or appendix is tunneled into the bladder wall creating a continence valve. The aim of this study is to compare the outcomes of these 2 techniques in the adult population.
Methods: We reviewed the charts of 151 patients from 7 sites in North America from NBRG who underwent bladder augmentation with a catheterizable channel between July 2007 and September 2017 using either CCIC or IC. 20 patients were excluded due to age < 18 (1) or follow-up < 6 months (19). We evaluated patient demographics, modality and type of surgery, 90-day complications and readmissions, follow-up surgeries, and abandonment of channels.
Results: A total of 131 patients with a median age of 38 years were included in the study; 104 (79%) underwent CCIC and 27 (21%) underwent IC with a catheterizable channel. 46 (35%) were male, and spinal cord injury was the leading etiology (59, 45%). Prior to surgery, most patients' bladder management was indwelling urethral catheter or suprapubic tube (59, 45%) followed by clean intermittent catheterization (49, 37%). There were no statistically significant differences between CCIC and IC patients for major complications (13% vs. 4%, p = 0.31) or 90-day readmissions (21% vs. 7%, p = 0.16). During the follow-up period (median 41.5 months), 22 (21%) CCIC patients underwent catheterizable channels revision surgery vs. 8 (30%) IC patients (p = 0.44). 5 (5%) CCIC patients ultimately abandoned their channels vs. 1 (4%) IC patient (p = 1.00).
Conclusions: This is the first contemporary multicenter series comparing two different techniques for bladder augmentation in the adult population. CCIC patients had more post-operative complications and readmissions than IC patients, but these differences were not statistically significant.