Table 3 Overview of late complications (>3 months) (pouch and non-pouch-related) by the Clavien–Dindo classification in 111 patients
From: The N-shaped orthotopic ileal neobladder: functional outcomes and complication rates in 119 patients
Clavien–Dindo score (CCS) | Number of complications (%) |
|---|---|
Major | |
V | 1 (0.9 %) |
IV | |
a | 4 (3.6 %) |
b | 0 (0 %) |
III | |
a | 2 (1.8 %) |
b | 49 (44.1 %) |
Minor | |
II | 28 (25.2 %) |
I | 11 (9.9 %) |
Complication | N (%) | CCS | Treatment |
|---|---|---|---|
Late pouch-related complications | |||
Major | |||
Death (abscess formation in base of penis after false-passage catheterization, resulting in sepsis + multiple organ failure) | 1 (0.9 %) | V | Debridement + Intensive care |
Loss of renal unit | 2 (1.8 %) | IVa | Conservative |
Ischemic perforation of neobladder | 1 (0.9 %) | IVa | Laparotomy + Intensive care |
Urosepsis | 1 (0.9 %) | IVa | Intensive care + Conservative therapy |
Pouch calculi | 8 (7.2 %) | IIIb | Laser lithotripsy |
Neovesicourethral stenosis | 11 (9.9 %) | IIIb | Internal optical urethrotomy (4×) Transurethral resection (5×) Dilatation under general anesthesia (2×) |
Ureteroneovesical stenosis | 6 (5.4 %) | IIIb | Ureteral reimplantation (4×) Lifelong single-J stenting (2×) |
Stress incontinence | 2 (1.8 %) | IIIb | Single incision mid-urethral sling (1×) Fascia lata sling (1×) |
Mucus obstruction | 1 (0.9 %) | IIIb | Endoscopic evaluation |
Neovesicocutaneous fistula | 1 (0.9 %) | IIIb | Open excision |
Neovesicorectal fistula | 1 (0.9 %) | IIIb | Laparotomy + Conversion to ileal conduit |
Hypercontractile neobladder with severe incontinence | 1 (0.9 %) | IIIb | Laparotomy + Conversion to ileal conduit |
Ureterolithiasis | 1 (0.9 %) | IIIa | Nephrostomy |
False-passage catheterization | 1 (0.9 %) | IIIa | Endoscopic evaluation |
Minor | |||
Relapsing urinary tract infections and pyelonephritis | 26 (23.4 %) | II | Antibiotics |
Urosepsis | 2 (1.8 %) | II | Antibiotics + Fluid resuscitation |
Mucus obstruction | 5 (4.5 %) | I | Conservative |
Late non-pouch-related complications | |||
Major | |||
Wound herniation | 17 (15.3 %) | IIIb | Open repair |
Small bowel obstruction | 1 (0.9 %) | IIIb | Open adhesiolysis |
Minor | |||
Diarrhea | 6 (5.4 %) | I | Conservative |