Concurrent placement of a mesh during formation of ileal conduit will decrease the incidence
of parastomal hernia and associated complications.
Subject to inclusion and exclusion criteria, patients will be randomized 1:1 to the control
and intervention groups:
- Group 1 (control): Ileal Conduit
- Group 2 (intervention): Ileal conduit with concurrent mesh placement.
Ethicon PHYSIOMESH composite mesh will be utilized for this study. This is a composite mesh
with a reduced polypropylene content. It is a widely used, commercially available hernia
mesh, and its use and placement are simple and well described. The mesh will be placed at the
time of radical cystectomy and ileal conduit. A small circle of mesh, the diameter of the
ileal conduit, will be excised to allow for fitment around the ileal conduit. The mesh will
be placed so that it encompasses the ileal conduit in a non-constricting manner, and will be
sutured to the anterior abdominal wall. Product will be stored in a secure, sterile manner at
the UMH operating room sterile supply room, and in accordance with institutional policies.
Patients from both groups will be followed up in a standard fashion. Follow up visits and
clinical assessment will be at 6 weeks after surgery, 3 monthly during the first year, then
every 6 months for at least 5 years. During each visit, patients will be clinically evaluated
for the presence or absence of parastomal hernia, and any routine surveillance radiology
imaging will be reviewed.
Parastomal hernia is clinically defined as an incisional hernia at the site of the ileal
conduit stoma. This may be clinically apparent by examining the patient during performance of
abdominal straining or Valsalva maneuver, or may be evident on radiology imaging.
1. Patients eligible to undergo urinary diversion with ileal conduit.
2. Patients with the ability to understand and willingness to sign a written informed
3. Men and Women aged 18 to 80 years.
1. Patients unable or unwilling to consent to the proposed surgery
2. Pregnant women
3. Patients with prior ileal conduit surgery undergoing revision.