Spinal Cord (2018) 56:856–862 https://doi.org/10.1038/s41393-018-0083-1 ARTICLE Complications of non-continent cutaneous urinary diversion in adults with spinal cord injury: a retrospective study Cyrille Guillot-Tantay 1 ● Emmanuel Chartier-Kastler 1 ● Marie-Aimée Perrouin-Verbe 1 ● Pierre Denys 2 ● Priscilla Léon 1 ● Véronique Phé 1 Received: 12 September 2017 / Revised: 8 February 2018 / Accepted: 12 February 2018 / Published online: 7 March 2018 © International Spinal Cord Society 2018 Abstract Study design Retrospective cohort study. Objectives To report the long-term complications of non-continent cutaneous urinary diversion (NCCUD) in adult patients with spinal cord injury (SCI). Setting Hospital in Paris, France. Methods A retrospective single center study included all adult patients with SCI who underwent an ileal conduit between 1997 and 2014. Early complications were reported according to Clavien-Dindo classification. Long-term complications and reoperation rates were recorded, as well as stoma management and autonomy improvement related to urinary function. Results One hundred and two patients were included. The surgical indications included failure of intermittent catheterization (n = 43), urethral fistulae due to skin ulcers (n = 50), renal failure (n = 8), recurrent urinary tract infections (n = 9), lithiasis (n = 3), and bladder tumors (n = 2). There were 67 early postoperative complications for 44 patients (43%) leading to an additional surgery in 15 cases: 30 grade I–II, 30 grade III, 6 grade IV, and 1 grade V. A total of 37 late complications were reported for 36 patients (35%): 17 ureteral anastomosis stenosis, 3 stoma hernia, 3 pyocystis (3/15 patients), 7 pyelone- phritis, 2 renal failures, 2 ureteral lithiasis, 1 uterine prolapse, 1 incisional hernia, and 1 tumor recurrence. Renal function remained unchanged (p = 0.53). Autonomy related to urinary function was improved in 88% of patients. The correct fitting of the stoma was possible for 81% of the patients. Conclusions Despite a perioperative morbidity rate of 43% and a late complication rate of 35%, as a last resort procedure, NCCUD is an end-stage solution in patients with SCI to preserve renal function and achieve autonomy. Introduction The combination of intermittent self-catheterization (ISC), described initially by Lapides et al. [1] in 1972 with the treatment of neurogenic detrusor overactivity is recom- mended in neurological patients with spinal cord disease in order to improve the storage phase, protect the upper urin- ary tract, and achieve urethral continence [2, 3]. In case of failure of conservative therapy, non-continent cutaneous urinary diversion (NCCUD) can be offered to these patients in whom ISC cannot be performed due to anatomical bar- riers, cognitive impairment, or limited dexterity [4, 5]. Ultimately, NCCUD can be considered in patients who use wheelchairs or are restricted to bed (skin ulcers included), with intractable and untreatable incontinence, in devastated lower urinary tract symptoms, when the upper urinary tract is severely compromised, and in patients who reject other therapy. The ileal conduit described by Bricker [6] in 1950 is most commonly used and diverts the urine regardless of whether or not a cystectomy is performed [7]. The ileal conduit has been largely reported after pelvic cancer surgery but remains seldom used for the management of neurogenic bladder, since the use of less invasive therapies is preferred * Cyrille Guillot-Tantay c.guillot.tantay@gmail.com 1 Department of Urology, Pitié-Salpêtrière Academic Hospital, Assistance Publique-Hôpitaux de Paris, Pierre and Marie Curie Medical School, Sorbonne Universités, Paris 6 University, Paris, France 2 Department of Physical Medicine and Rehabilitation, Raymond Poincaré Academic Hospital, Garches, Assistance Publique- Hôpitaux de Paris, Paris-Ouest Medical School, Versailles-Saint- Quentin en Yvelines University, Montigny le Bretonneux, France 1234567890();,: