Continent heterotopic derivation of urine in a partially isolated segment of the sigmoid intestine after cystprostatectomy

From 1992 to 2006 cystprostatectomy with continent heterotopic urine derivation in a partially isolated segment of the sigmoid intestine was made in 37 males aged 39-78 years. The patients had the following tumor stages: 2 patients with T2NXM0, 20 patients with T3NXM0, 6 patients with T3N1M0, 9 patients with T3-4N1MX. Thirty patients (81%) had no complications in an early postoperative period, 7 (19%) had complications: purulent pyelonephritis (n = 2), wound suppuration (n = 3), intestinal eventration (n = 1), interintestinal abscess (n = 1). There were two lethal outcomes early after operation: one patient died of bilateral purulent pyelonephritis and the other one - of acute cardiac failure. For 3 years 27 (77%) of 35 patients had satisfactory quality of life. Thus, urine derivation by simple methods one of which is creation of a partially isolated reservoir from a sigmoid segment with transanal urine derivation is indicated after cystprostatectomy for elderly males with a high risk of postoperative complications and lethality (stage T2-T3NXMX) and unclear distant metastases.