Delayed complication of pelvic lymphocele: Ileal conduit obstruction

Ileal conduit obstruction secondary to tethering of the small bowel anastomosis to the pubic bone

We present the case of a late 60s male who presented to hospital 3 years postradical cystectomy and ileal conduit diversion with polyuria and acute kidney injury. CT of the kidneys, ureters and bladder (KUB) revealed mild hydronephrosis of a solitary left kidney and a 3-cm calculus in the ileal conduit. The patient subsequently underwent a laparotomy which revealed the cause of obstruction to be tethering of the small bowel anastomosis to the pubic bone. The conduit was excised with the calculus in situ and a new conduit was fashioned. The patient recovered from surgery without complication, and his kidney function improved.

Fistula formation between infected pelvic lymphocele and sigmoid colon: A rare complication of pelvic lymphadenectomy

Lymphocele formation following pelvic lymphadenectomy is a well-known complication. In this article, we report a 56 years old female patient with a pelvic infected lymphocele fistulised in the sigmoid discovered in imaging 2 months after pelvic surgery. Lymphocele complications are rare and their diagnosis is based on imaging. However, lymphocele as a potential cause for fistula in the bowel as a particular new case has not been found in literature search.

Postoperative management of radical cystectomy. Review of the evidence on the prevention and treatment of urological complications

INTRODUCTION AND OBJECTIVES

This review article focuses on the prevention and management of the most common postoperative urological complications of radical cystectomy. We reviewed the current literature and conducted an analysis of frequency, prevention and treatment of complications.

ACQUISITION OF EVIDENCE

We conducted a search on Medline to identify original articles, literature reviews and editorials focusing on the urological complications of radical cystectomy during the first 90 days after surgery. We identified those series that included more than 100 patients.

SYNTHESIS OF THE EVIDENCE

The literature regarding the prevention and treatment of complications after cystectomy is in general retrospective and nonstandardised. The level of evidence is generally low, and it is difficult to make evidence-based recommendations.

CONCLUSIONS

Progress has been made in recent years in reducing mortality and preventing the complications of cystectomy. The most common complications are gastrointestinal, for which significant efforts have been made to implement ERAS and Fast Track protocols. The complications that can most significantly change patients' quality of life are urinary stoma.