Peer-reviewed veterinary case report
Preventing hernias after bladder removal with ileal conduit surgery
By Rossin G et al.·2026·Urological Clinic, Italy·View original on Europe PMC →
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Original publication title: Preventing Parastomal Hernias After Radical Cystectomy with Ileal Conduit: A Systematic Review Regarding Surgical Prophylactic Techniques.
Plain-English summary
After a surgery called radical cystectomy, which involves removing the bladder and creating a new way for urine to leave the body using a piece of the intestine (called an ileal conduit), some patients can develop a problem known as a parastomal hernia. This is when tissue bulges through the abdominal wall near the stoma (the opening created for urine). Researchers looked at various studies to see how effective different methods are at preventing this issue. They found that using mesh to support the area had varying success rates, while other non-mesh techniques also showed promise. However, the overall quality of the studies was low, so more research is needed to draw firm conclusions about the best ways to prevent these hernias.
Abstract
<b>Background/Objective</b>: Parastomal hernia (PSH) following radical cystectomy (RC) with ileal conduit represents a significant late complication. Preventive strategies have been described but are not yet routinely incorporated into clinical practice. We conducted a systematic review of the current literature to assess the efficacy of PSH preventive techniques for ileal conduit. <b>Methods</b>: A literature search of PubMed/MEDLINE, Scopus, CENTRAL, and Web of Science databases was conducted from 2010 to December 2024 following PRISMA guidelines. Inclusion criteria were patients undergoing RC with ileal conduit, evaluation of at least one PSH preventive strategy and reporting of PSH incidence or relevant postoperative outcomes. Eligible designs included RCTs and non-randomized cohort studies. Exclusion criteria included urinary diversions other than ileal conduit, non-bladder-related indications, non-extractable outcome data, and non-original publications. <b>Results</b>: Three randomized controlled trials (RCTs) and nine non-randomized studies were included in the analysis. Studies investigating both mesh and non-mesh preventive techniques were considered. Clinical PSH recurrence rates following mesh placement ranged from 0.0% to 11.1% among the included studies. RCTs using mesh placement reported conflicting conclusions regarding its protective effects. For non-mesh preventive strategies, clinical PSH recurrence rates ranged from 0.0% to 11.5%. The only RCT focusing on non-mesh approaches reported positive protective effects for the experimental group. All procedures were safe, with no significant increase in complication rates compared to conventional interventions. <b>Conclusions</b>: The low quality of current evidence prevents definitive conclusions regarding the protective effects of both mesh and non-mesh preventive approaches. High-quality evidence is needed to make conclusive statements on this topic. Patients at high risk for PSH development should be offered personalized preoperative counselling and the opportunity to participate in ongoing RCTs.
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Search related cases →Original publication on Europe PMC: https://europepmc.org/article/MED/41590533