Evaluation of Upper Urinary Tract Integrity After Radical Cystectomy and Orthotopic Diversion with Ileal and Sigmoid Neobladder

The study aims to evaluate the effects of orthotopic urinary diversion using ileal and sigmoid segments after radical cystectomy on upper urinary tract function and morphology. A retrospective study included 60 patients divided into 2 equal groups (W-ileal pouch group and sigmoid pouch group). We assessed renal function and morphology post-operative after 6 months and after 1 year by serum creatinine, ultrasound, IVP, pouchogram, and renal scan study. After 6 months post-operatively, in the W-ileal group, there were 16 renal units (26.6%) deteriorated in morphology and 11 renal units (18.4%) deteriorated in function. After 1 year, further deterioration in morphology was noted in 17 renal units (28.3%) and in function in 16 renal units (26.7%). In the sigmoid group, after 6 months post-operatively, there were 14 renal units (23.3%) deteriorated in morphology and 14 renal units (23.4%) deteriorated in function. After 1 year, further deterioration in morphology was noted in 47 renal units (24.4%) and in function in 18 renal units (30%). Incorporating the bowel into the urinary tract is potentially dangerous to the upper urinary tract's integrity, and the leading cause of renal impairment is uretero-pouch obstruction.