Pyrah technic for ileal conduit diversion: a 16-year experience

At our institution, 100 patients had ileal conduit diversion using the Pyrah technic between 1959 and 1975. The results of this technic compare favorably with those of other ileal conduit diversions, and it has the advantage of being somewhat shorter than the standard Bricker procedure. Sixty-seven were done because of benign lesions of the urinary tract and 33 were done as part of the planned treatment of various malignant conditions. We did 56 diversions in patients with neurogenic bladder dysfunction. There were 67 early and 69 late complications, and the complication rate was much higher in patients having preoperative irradiation. The most common complications were wound infections, pyelonephritis, ureteroileal anastomotic leaks or stricture, and stomal stenosis. The upper urinary tracts showed signs of progressive deterioration after diversion in 19% of patients. The operative mortality was 6%. The mortality was four times greater in the group with malignant conditions.