67th Annual Meeting Abstracts

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Ileovesicostomy for Neurogenic Bladder Dysfunction
Blake W Moore, Ashley B King, *Albert A Petrossian, Lance Hampton, Baruch M Grob, Georgi Guruli, Adam P Klausner
Virginia Commonwealth University, Medical College of Virginia; McGuire Veterans Administration Hospital, Richmond, VA

Introduction: The purpose of this investigation was to characterize the results and complications of a series of patients treated with illeovesicostomy for neurogenic bladder dysfunction.
Methods: Fifteen patients who underwent ileovesicostomy for neurogenic bladder dysfunction from June, 2005 to January, 2009 at two academic medical centers were identified retrospectively. Patient data including medical co-morbidities, prior surgery, preoperative bladder management as well as operative factors, postoperative complications, and degree of incontinence were collected. Data is reported as means ± SEM.
Results: Fifteen patients underwent ileovesicostomy with a mean age of 43.8 ± 3.2 years; eight of fifteen (53%) were white with an average BMI of 24.3 ± 1.4. Fourteen of fifteen (93%) managed their bladders with indwelling catheters preoperatively for a mean duration of 6.44 ± 1.36 years. Mean operative time was 282 ± 47.4 minutes with an average estimated blood loss of 217 ± 25 ml. Average length-of-stay was 9 ± 1.25 days with the most common postoperative complication being ileus (53.3%). Three patients had serious complications, including one with a bladder anastamotic leak that was managed conservatively, and two with sepsis. There were no deaths and no thromboembolic events. One patient (6.7%) required reoperation with conversion to ileoconduit for persistent incontinence. At last follow up, 66.7% were continent per urethra. Average follow up time was 19.3 ± 3.4 months.
Conclusions: Ileovesicostomy is an effective option for management of neurogenic bladder dysfunction with excellent urethral continence (67%) despite high, but acceptable, rates of postoperative morbidity.

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