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Use of Urostomy Bags in the Management of Perioperative Urine Leakage After Radical Cystectomy

Li, Xuemei BS; Fang, Qiang MD; Ji, Huixiang MD; Pan, Jinhong MD; Zhang, Jing BS; Li, Zhenyan BS; Chen, Min BS; Wu, Xiaojun MD; Zhou, Zhansong MD; Chen, Zhiwen MD

doi: 10.1097/NCC.0b013e318277db29
Articles

Background: Urine leakage is a common complication in patients with bladder cancer after radical cystectomy and neobladder reconstruction.

Objective: The aim of this study was to evaluate the clinical value of the use of urostomy bags in the management of urine leakage in patients with bladder cancer after radical cystectomy.

Methods: Urine leakage during the perioperative period was retrospectively analyzed in 483 patients with bladder cancer who underwent radical cystectomy from 2004 to 2010. Before 2008, all patients with urine leakages were treated by routine dressing changes (group A). After 2008, the leakages were managed with urostomy bags (group B). The perioperative quality of life (EQ-5D) and cost for urine leakage for both groups were compared in this controlled study.

Results: The average cost in management of preoperative urine leakage was significantly higher in group A than in group B as well as the patients with extravasations of urine or lymphoceles. Patients in group B had an overall better perioperative life quality compared with group A. In particular, the score for pain/discomfort was significantly higher in group A than in group B.

Conclusions: The management of perioperative urine leakage with urostomy bags avoided constant body wetness and significantly increased the quality of life and reduced the special costs of urine leakage in patients with bladder cancer after cystectomy.

Implications for Practice: Early use of urostomy bag is a good choice for perioperative urine leakage in patients with bladder cancer after radical cystectomy and neobladder reconstruction.

Author Affiliations: Section of Urological Oncology, Urology Institute of the People’s Liberation Army, and Southwest Cancer Center, Southwest Hospital, Third Military Medical University, Chongqing, People’s Republic of China.

Drs X. Li and Fang contributed equally to this study.

This work was supported by the clinical innovation fund of TMMU (2010XLC02).

The authors have no conflicts of interest to disclose.

Correspondence: Zhiwen Chen, MD, Urology Institute of the People’s Liberation Army and Southwest Cancer Center, Southwest Hospital, Third Military Medical University, #30, Gao Tan Yan, Chongqing 400038, People’s Republic of China ( zhiwen@tmmu.edu.cn).

Accepted for publication October 5, 2012.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins