Urinary fistulas after ureteral diversion

Twenty-three (5.7 per cent) of 402 patients who had ureteral diversion with or without organ resection for cancer and related conditions at Ellis Fischel State Cancer Hospital had early postoperative urinary leaks. Patients with prior pelvic irradiation and with diabetis mellitus were at higher risk than others to develop a urinary fistula. The hospital mortality among the twenty-three patients with this complication was 47.8 per cent. Additional complications were often associated with urinary fistulas and contributed to the high mortality. The most frequent site of leakage from an ileal segment diversion was the ureteroileal anastomosis and the most reliable means of diagnosis was the retrograde ileogram.