Risk of bowel dysfunction with diarrhea after continent urinary diversion with ileal and ileocecal segments.

Abstract

In a retrospective study we evaluated the risk of diarrhea after continent urinary diversion using ileal and ileocecal segments. We interviewed 100 patients of whom 65 underwent ileal and 35 underwent ileocecal resection. Of the 65 patients who underwent ileal resection 7 (11%) and of the 35 who underwent ileocecal resection 8 (23%) reported chronic diarrhea of greater than 6 months in duration, which subsided spontaneously in 2 patients in each group. In each group 3 patients responded well to cholestyramine treatment and 3 responded to loperamid or psyllium. Two patients with ileocecal resection failed to respond to drug therapy. The risk of diarrhea after ileocecal resection seems to be twice as high as after ileal resection. Most patients responded to symptomatic drug therapy. Alternative surgical therapies should be considered when risk factors are present.