Introduction: Parastomal hernia (PH) represents an important late complication after radical cystectomy that affects patient´s quality of life. Our objective is to analyze the prevalence of clinical and radiologic PH and identify risk factors. Methods: We retrospectively analyzed RC patients with ileal conduit, from 2016 till 2021with minimum one year follow-up. Independent radiologists analyzed the presence of radiologic PH at first year CT scan, using both Moreno-Matias (M-M) and European Hernia Society (EHS) classification. Multivariate regression was performed to identify clinical and surgical factors (surgical approach, fixation to aponeurosis, surgical time..) associated with PH Results: A total of 161 patients underwent RC with ileal conduit were included, with mean age at surgery of 69 (SD=7,5). 55% (n=90) were done robot assisted, 15% (29) laparoscopically and 25% (46) open. 21 (13%) patients had clinical PH, with mean time to diagnosis of 23 months. Prevalence of radiologic hernia was 43% (70 patients). Both M-M and EHS classifications were correlated to the presence of clinical PH. On multivariate regression, BMI was independent predictor of radiologic PH (HR=1.056 for every unit). Neither surgical approach (open, robot or laparoscopic) nor surgical fixation of the ileal conduit to the aponeurosis were associated to radiologic PH. Conclusions: Radiologic PH is a prevalent finding on first year after RC, while clinical PH is found in 12% of the patients. In our series, only BMI was an independent predictor. Surgical technique was not associated with the risk of PH development. SOURCE OF Funding: None
