Ileal Conduit Versus Cutaneous Ureterostomy After Radical Cystectomy
Ileal Conduit Versus Cutaneous Ureterostomy After Radical Cystectomy
Bladder cancer is the most common malignancy of the urinary tract and accounts for about 3.2%
 of all cancer worldwide where it remains the seventh most commonly diagnosed malignancy in
 the male population. Causative risk factors can be broadly divided into inherited and
 acquired due to environmental exposure ,Tobacco smoking is the most important environmental
 risk factor for bladder cancer(1).

 Histologically, over 90% of bladder tumors are transitional cell carcinomas. The other
 subtypes, such as squamous cell and adenocarcinoma, are uncommon and account for 5 and <2%,
 respectively(2).

 Radical cystectomy with pelvic lymph node dissection with appropriate urinary diversion
 remains the mainstay of surgical treatment for muscle invasive bladder cancer and for high
 risk non muscle invasive disease. Select group of patients or those unfit or unwilling for
 surgery are managed by trimodal therapy utilizing transurethral resection and
 chemoradiotherapy.(3) The ideal urinary diversion should successfully preserve renal function
 while managing urinary outflow and minimizing morbidity to the patient(4).Several types of
 urinary diversion are present, continent and incontinent. Our study will focus on ileal
 conduit and cutaneous ureterostomy.

 Although ileal conduit considered the standard method for incontinent urinary diversion, it
 is associated with early bowel related complications, i.e., bowel obstruction, prolonged
 ileus, and anastomotic leak which are mainly associated with bowel resection and anastomosis
 and late complications comprise ureteroenteric stricture, urinary fistula and stomal site
 complications in 25-60% of patients, including stomal stenosis, retraction, prolapsed, and
 parastomal herniation. Cutaneous ureterostomy may represent a method of choice for elderly
 and otherwise morbid patients due to its relative short duration and less bowel and metabolic
 complications but it has a high rate of stomal stenosis making perminant stenting is
 mandatory(5).

 Cutaneous ureterostomy with separate stomas offers easy exchange of stents not need tertiary
 center with fluoroscopy or endescopy guidance compared to cutaneous ureterostomy with single
 stoma and this is preferable in our community.
Inclusion Criteria:

 -  patients with bladder cancer eligible for surgery

 Exclusion Criteria:

 -  Patients who refuse to contribute in this study.

 -  patients who are unfit for surgery.

 -  patients refusing cystectomy.

 -  patients with metastatic or inoperable cancer bladder