Novel creation of a non-everted stoma during ileal conduit urinary diversion: technique and short-term outcomes

Objective To report our experience with a non-everted stoma technique used in ileal conduit urinary diversion. We successfully utilize this technique in patients when traditional everted stoma maturation is difficult due to a thick abdominal wall, bulky mesentery, and poor bowel compliance. Methods We retrospectively reviewed all patients who underwent surgical creation of ileal conduit using a non-everted stoma technique between 2009 and 2018. We recorded demographic and perioperative information, including 30-day postoperative complications, and stoma appearance at last follow up visit. Using R software, chi-square testing of the distribution of stoma outcomes for obese and non-obese patients was performed. Results There were a total of 42 patients who a underwent non-everted stoma maturation technique by a single surgeon. Our cohort meets obese criteria with a mean BMI of 30.2. Mean length of follow up was 16.6 months (1-62). On follow-up 35 (83.3%) of stomas were pink and everted appearing, 4 (9.5%) were flush, small, or non- everted, 1 (2.3%) had an eschar or area of granulation tissue around the stoma, and 2 (4.7%) did not have a stoma description documented. There were 9 (21%) stoma related complications in our cohort. There was no statistical difference in stoma outcomes between obese (BMI>30) and non-obese (BMI Conclusions Ileal conduit creation with a non-everted stoma provides good stoma protuberance in patients with a thick abdominal wall, bulky mesentery, and poor bowel compliance. This technique is safe and should be considered in patients in whom stoma maturation is difficult.