ArticleCentral European journal of urology2026
Preventing parastomal hernia following radical cystectomy with ileal conduit diversion: outcomes of prophylactic mesh reinforcement.
Article in Central European journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Parastomal hernia (PH) is a frequent long-term complication following radical cystectomy with ileal conduit urinary diversion. Evidence supporting preventive strategies in urologic surgery remains limited. This study evaluated the impact of prophylactic mesh reinforcement during ileal conduit formation on PH incidence and postoperative outcomes. Material and methods: In this prospective, single-center cohort study, 70 patients undergoing open radical cystectomy with ileal conduit diversion were included. Prophylactic retromuscular mesh was placed at the stoma site in 10 patients (mesh group), while 60 patients underwent standard stoma construction (control group). The primary endpoint was PH occurrence. Secondary endpoints included stomal, bowel, wound, and infectious complications. Multivariable logistic regression was performed to identify predictors of PH in the control cohort. Results: PH occurred in 20 of 60 patients (33.3%) in the control group and in none of the patients in the mesh group (0%), representing a statistically significant difference (p = 0.043). Overall stomal complications were significantly reduced in the mesh group (0% vs 36.7%; p = 0.025). Operative time was significantly longer in the mesh group; however, no increase in bowel, wound, infectious complications, transfusion requirement, or reoperation rate was observed. Multivariable analysis identified increasing age, higher body mass index, and female sex as independent predictors of PH. Obese patients (BMI >30) demonstrated a significantly higher PH incidence compared with non-obese patients (42.9% vs 28.2%; p = 0.032). Conclusions: Prophylactic mesh reinforcement during ileal conduit formation significantly reduced parastomal hernia incidence and overall stomal complications without increasing perioperative morbidity.
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