Long-term complications and functionality after continent cutaneous urinary diversion

INTRODUCTION. Data are limited on the functional outcomes of continent cutaneous urinary diversions (CCUD) to guide shared decision-making regarding urinary diversion. The objective of this study was to investigate long-term outcomes for patients who had undergone cystectomy with CCUD construction at a specialised tertiary centre. METHODS. Data were retrospectively obtained by manual review of 50 medical records of patients who underwent cystectomy with a CCUD from 2010-2023 at a single centre in Denmark. The primary outcome was continence rate, and secondary outcomes included late reinterventions and the associated cumulative risk, late complications and kidney function after cystectomy with a CCUD. Outcomes were presented as the number of patients and the percentage of the patient population, and the median number of days since cystectomy. The cumulative risk of reintervention was calculated as a competing risks analysis. RESULTS. The median follow-up was 5.7 years (IQR: 2.9-9.7 years). Three-hour continence was reached by 92% of patients at a median of 167 years (IQR: 75-229 days) after surgery. All patients managed clean intermittent catheterisation at a median of 23 days (IQR: 20-33 days) after surgery. A total of 33 patients underwent a reintervention procedure, with an absolute five-year cumulative risk of reintervention of 71% (95% CI: 57-85%). CONCLUSIONS. Most patients who received a CCUD reached continence within six months of surgery. Two of three patients needed at least one reintervention.