• Logo
  • SBMUJournals

Urinary and Fecal Diversion Following Pelvic Exenteration: Comparison of Double-Barrelled and Plain Wet Colostomy

Sertac Yazici, Senol Tonyali, Ali Cansu Bozaci, Hakan Bahadir Haberal, Erhan Hamaloglu, Haluk Ozen




Purpose: To assess early and late-term outcomes of patients who had undergone pelvic exenteration and simultaneous fecal and urinary diversion with plain wet colostomy (PWC) or double-barrelled wet colostomy (DBWC).
Materials and Methods: The medical records of all patients who had undergone pelvic exenteration and urinary diversion between 2006 and 2017 at our hospital were reviewed retrospectively.
Results: In total, 15 patients with a mean age of 56 ± 13 years were included in the study. Simultaneous urinary and fecal diversions were carried out as PWC (n = 8), or DBWC (n = 7). No significant differences were found between PWC and DBWC groups in terms of operation time (373.7 ± 66.5 versus 394.2 ± 133.2 min, P = .955), estimated blood loss (862.8 ± 462.4 versus 726.2 ± 489.4 mL, P = .613), length of hospital stay (13.2 ± 9.1 versus 14.1 ±6.9 days), early complications (25% versus 28.6%, P = 1.0) and late term complications (37.5% versus 42.9%, P = 1.0). The rate of recurrent pyelonephritis in PWC group was higher than DBWC group but not statistically significant (37.5% versus 14.3%, P = .569). Overall survival (OS) of the patients was 385 ± 91 days. There was no difference between OS of patients with PWC and DBWC (414 ± 165 versus 352 ± 70 days, P = .618).
Conclusion: PWC and DBWC are valid options for creating simultaneous urinary and fecal diversion after extensive pelvic surgery in patients with short life expectancy. DBWC might be superior to PWC in terms of decreased risk of recurrent pyelonephritis.



Brunschwig A. Complete excision of pelvic viscera for advanced carcinoma; a one-stage abdominoperineal operation with end colostomy and bilateral ureteral implantation into the colon above the colostomy. Cancer. 1948;1(2):177-83.

Brunschwig A, Daniel W. Pelvic exenteration operations: with summary of sixty-six cases surviving more than five years. Ann Surg. 1960;151:571-6.

Wear JB, Jr., Barquin OP. Ureterosigmoidostomy. Long-term results. Urology. 1973;1(3):192-200.

Bricker EM. Bladder substitution after pelvic evisceration. Surg Clin North Am. 1950;30(5):1511-21.

Carter MF, Dalton DP, Garnett JE. Simultaneous diversion of the urinary and fecal streams utilizing a single abdominal stoma: the double-barreled wet colostomy. J Urol. 1989;141(5):1189-91.

Kristjansson A, Mansson W. Refluxing or nonrefluxing ureteric anastomosis. BJU Int. 1999;84(8):905-10.

Carter MF, Dalton DP, Garnett JE. The double-barreled wet colostomy: long-term experience with the first 11 patients. J Urol. 1994;152(6 Pt 2):2312-5.

Guimaraes GC, Ferreira FO, Rossi BM, et al. Double-barreled wet colostomy is a safe option for simultaneous urinary and fecal diversion. Analysis of 56 procedures from a single institution. J Surg Oncol. 2006;93(3):206-11.

Kecmanovic DM, Pavlov MJ, Ceranic MS, Masulovic DM, Popov IP, Micev MT. Double-barreled wet colostomy: urinary and fecal diversion. J Urol. 2008;180(1):201-4; discussion 4-5.

Gan J, Hamid R. Literature Review: Double-Barrelled Wet Colostomy (One Stoma) versus Ileal Conduit with Colostomy (Two Stomas). Urol Int. 2017;98(3):249-54.

Urdaneta LF, Duffell D, Creevy CD, Aust JB. Late development of primary carcinoma of the colon following ureterosigmoidostomy: report of three cases and literature review. Ann Surg. 1966;164(3):503-13.

Osorio Gullon A, de Oca J, Lopez Costea MA, et al. Double-barreled wet colostomy: a safe and simple method after pelvic exenteration. Int J Colorectal Dis. 1997;12(1):37-41.

Blanco Diez A, Fernandez Rosado E, Alvarez Castelo L, et al. [Double-barreled wet colostomy: analysis of a urinary diversion]. Actas Urol Esp. 2003;27(8):611-7.

Takada H, Yoshioka K, Boku T, et al. Double-barreled wet colostomy. A simple method of urinary diversion for patients undergoing pelvic exenteration. Dis Colon Rectum. 1995;38(12):1325-6.

Lopes de Queiroz F, Barbosa-Silva T, Pyramo Costa LM, et al. Double-barrelled wet colostomy with simultaneous urinary and faecal diversion: results in 9 patients and review of the literature. Colorectal Dis. 2006;8(4):353-9.

Teicher I, Karlitz LM, Shaftan GW. Complications of a wet colostomy after pelvic evisceration corrected by separation of urinary and fecal streams; report of a case. Ann Surg. 1953;137(1):129-34.

Valle M, Federici O, Ialongo P, Graziano F, Garofalo A. Prevention of complications following pelvic exenteration with the use of mammary implants in the pelvic cavity: Technique and results of 28 cases. J Surg Oncol. 2011;103(1):34-8.

DOI: http://dx.doi.org/10.22037/uj.v0i0.4461


  • There are currently no refbacks.