Incisional and Parastomal Hernia following Radical Cystectomy and Urinary Diversion: The University of Southern California Experience

Purpose: Hernia is a common complication following radical cystectomy and urinary diversion. We investigated the clinical and radiological evidence for parastomal and incisional hernias, and their risk factors in a large cohort.Materials and Methods: Using an institutional review board approved prospective database we reviewed the records of 1,101 patients who underwent radical cystectomy from 2003 to 2013. Followup (median 57 months) was available for 670 patients. Of the 670 patients 92 underwent ileal conduit diversion using Turnbull stomas with a median followup 34 months. Patients were followed with computerized tomography cancer surveillance. Standardized criteria were used to define parastomal and incisional hernias by an expert radiologist. Multivariate logistic regression was done to identify independent predictors.Results: Parastomal hernia was diagnosed in 21 of 92 patients (23%) with a mean age at diagnosis of 76.5 years. Incisional hernia was present in 125 of 670 patients (18.7%) with a mean...