in this arm -study group- : patients will receive mesh stoma reinforcement technique with ileal conduit urinary diversion.

in this arm -sham comparator- : patients will not receive mesh stoma reinforcement technique with ileal conduit urinary diversion.

Ileal Conduit

Parastomal Hernia

After standard steps of radical cystectomy and sparing of distal 15 cm of ileum as a conduit for diversion.
A preferred rectal muscle splitting approach is preferred for IC exteriorization.
Dissection of subcutaneous fat off the rectus sheath will be accomplished to create a potential space for mesh placement.
Then, 5 x 5 cm polypropylene mesh will be placed and incised at the center to create an orifice to allow IC exteriorization.
The mesh is then fixed to underlying rectus sheath with 1-0 non-absorbable proline sutures.
The IC is exteriorized through the central orifice and then fixed to the peritoneum and to the cut-edges of the rectus muscle using 3-0 polyglactin sutures.
A 12 CH subcutaneous tube drain will be left and the subcutaneous tissue is closed to collapse the dissected space around the mesh.
The stoma is then everted and fixed to the skin.

Polypropylene Mesh Stoma reinforcement technique with ileal conduit urinary diversion

In this group, no mesh will be applied with ileal conduit urinary diversion

Ileal conduit urinary diversion

Urology and Nephrology Center

Role of Mesh Stoma Reinforcement Technique (MSRT) in Prevention of Parastomal Hernia After Ileal Conduit Urinary Diversion

Role of Mesh Stoma Reinforcement Technique (MSRT) in Prevention of Parastomal Hernia After Ileal Conduit Urinary Diversion: A Randomized Controlled Trial

The primary outcome of this study will be the incidence of parastomal hernia at 2 years after surgery

The secondary outcome will be the adverse events related to mesh placement.

Health related quality of life issues will be assessed also in both groups.

hernia/proline

Role of Mesh Stoma Reinforcement Technique (MSRT) in Prevention of Parastomal Hernia After Ileal Conduit Urinary Diversion

Laparoscopic Intraperitoneal Mesh Repair of Ventral Hernia: Comparison to Conventional Mesh Repair

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