Introduction: Cutaneous ureterostomy (CU) urinary diversion after radical cystectomy has historically been relegated to highly comorbid patients due to presumed rates of stenosis and subsequent drainage tube dependence. Historically, rates of stricture as high as 70% have been reported and many leave patients entirely stent dependent for fear of stenosis related complications. Though a variety of techniques have been developed to obviate need for prolonged stenting, CU remains an uncommonly performed method of urinary diversion. We believe that rates of tube dependence in single-stoma CU are lower than anticipated and thus presents a viable option for all patients undergoing radical cystectomy. Methods: A retrospective review of patients having undergone radical cystectomy with single-stoma cutaneous ureterostomy from August 2020 to August 2022 by a single-surgeon, was performed. Demographic data and presence of stent, nephrostomy, or nephroureteral catheter was observed at last follow up. The primary outcome was “stent-free survival” incorporating all modalities of tube-dependent urinary drainage. Kaplan-Meier analysis was performed to determine stent-free survival at 6 and 12 months. Results: A total of 26 patients underwent radical cystectomy with cutaneous ureterostomy during this time period with a median age of 73 years (IQR: 64-78). Median body mass index was 25.45 (IQR: 22.75-28.7). At 6 months 76.6% of patients were tubeless and at 12 months 82.4% of patients were free of urinary drainage tubes. Four (15.4%) patients had continued tube dependence due to disease progression rather than CU stenosis. One (3.8%) patient expressed a strong desire to keep their stents. Conclusions: Single-stoma CU is a viable option for patients undergoing radical cystectomy with excellent tube-free rates at 1 year. Cutaneous ureterostomy should be considered a viable option for urinary diversion. Longer follow up is needed to assess durability of tube-free rates long term. SOURCE OF Funding: None
