Routine pouchograms are not necessary after continent urinary diversion

Objectives. Pouchograms are routinely performed before catheter removal after continent urinary diversion at our institution. Our aim was to determine the necessity of pouchograms based on a review of our experience. Methods. A retrospective review of patient records and radiographic studies was done for patients undergoing radical cystectomy and continent urinary diversions between 1991 and 2001. Results. Seventy-two patients underwent continent urinary diversion (orthotopic, n = 59; cutaneous, n 13) during the study period. All underwent pouchogram postoperatively (median 22 days; range 20 to 27). Six patients (8.3%) had a demonstrable radiographic leak; in 5 of the 6 patients, the urine leak was suspected on clinical grounds. Three patients (4.7%) developed urosepsis after pouchogram. Conclusions. Our findings indicate that routine pouchograms before pouch activation after continent urinary diversion may not be necessary.