Operative Mortality After Ureteroileal Diversion

Since the introduction by Bricker¹ of the use of isolated ileal segments as conduits for the diversion of the urinary stream, collective reviews of group and personal experiences with the procedure have been published. In 1956, Wells,² Annis,³ and Pyrah⁴ individually reviewed their experiences in successive papers appearing in the British Journal of Urology. Bricker⁵ published a short reappraisal in 1957. More recently, Stamey and Scott,⁶ Parkhurst and Leadbetter,⁷ Cordonnier and Nicolai,⁸ and Burnham and Farrer⁹ reviewed their experiences. These papers are collective reviews dealing with indications, techniques, complications, survival rates, changes in the upper urinary tract, and electrolyte absorption in a diverse group of patients. Operative mortality rates have varied markedly in these studies. The English workers' mortality rate approximates 25% with "ileus and burst abdomen," as defined by Pyrah, the most common cause of death. Parkhurst and Leadbetter reported