{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T01:17:42Z","timestamp":1792113462800,"version":"4.4.0"},"reference-count":14,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,11,30]],"date-time":"2023-11-30T00:00:00Z","timestamp":1701302400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>An Indiana Pouch (IP)\u00a0is a heterotopic, continent, urinary diversion from an ileocolonic segment. Numerous studies have investigated its long\u2010term outcomes, albeit none extending beyond a 5\u2010year follow\u2010up period. IPs can be used as urinary diversion for benign indications and as such are constructed in typically young patients. As a consequence of their extended lifespan, there is a need for very long\u2010term (&gt;5 years) IP outcome data and comprehensive complication analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>In this retrospective cohort study, the data of all patients attending our academic functional urology tertiary referral center for surveillance between 2015 and 2022 after an earlier IP procedure without uro\u2010oncological indication were analyzed. The primary objective was to identify the prevalence of complications associated with IP, including stomal stenosis, ureter\u2010pouch stenosis, pouch calculi, stomal leakage, pouch perforation, and parastomal herniation, and to determine the time span between creation of the IP and occurrence of complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A cohort of 33 patients (23 female) was analyzed. Median age at IP creation was 38 (range 5\u201362) years. Median follow\u2010up was 258 (range 24\u2013452) months. During follow\u2010up, 22 (67%) patients underwent at least one surgical revision. In total, 45 revision procedures were performed. The estimated mean revision\u2010free survival was 198 (95%\u2010CI 144\u2013242) months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Two\u2010thirds of our IP patients required surgical revision during very long\u2010term follow\u2010up. However, the mean revision\u2010free survival was 198 months. This establishes the IP as a durable and resilient option for urinary diversion, yet underlines the need for lifelong follow\u2010up as some of these complications and indication were subclinical. These results contribute significantly to patient counseling when discussing different options for urinary diversion, especially at a younger age.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nau.25344","type":"journal-article","created":{"date-parts":[[2023,11,30]],"date-time":"2023-11-30T13:44:16Z","timestamp":1701351856000},"page":"1090-1096","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Very long\u2010term follow\u2010up of Indiana Pouches\u00a0proves durability"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8403-5977","authenticated-orcid":false,"given":"Pepijn D.","family":"Polm","sequence":"first","affiliation":[{"name":"Department of Urology UMC Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1757-2569","authenticated-orcid":false,"given":"Michel I. A.","family":"Wyndaele","sequence":"additional","affiliation":[{"name":"Department of Urology UMC Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laetitia M. O.","family":"de Kort","sequence":"additional","affiliation":[{"name":"Department of Urology UMC Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,11,30]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.12121"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)44428-4"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2014.04.009"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-410X.2003.04330.x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.suronc.2012.02.001"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.01.023"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2011.12.050"},{"key":"e_1_2_9_9_1","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/j.acuro.2014.03.004","article-title":"Reservorio urinario continente cateterizable de Indiana","volume":"38","author":"Castillo OA","year":"2014","journal-title":"Actas Urol\u00f3gicas Espa\u00f1olas"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2007.09.008"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-4295(02)01945-3"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2004.07.018"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOU.0000000000000300"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000051462.45388.14"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2011.07.006"}],"container-title":["Neurourology and Urodynamics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nau.25344","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,2]],"date-time":"2024-11-02T03:27:06Z","timestamp":1730518026000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/nau.25344"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,30]]},"references-count":14,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1002\/nau.25344"],"URL":"https:\/\/doi.org\/10.1002\/nau.25344","archive":["Portico"],"relation":{},"ISSN":["0733-2467","1520-6777"],"issn-type":[{"value":"0733-2467","type":"print"},{"value":"1520-6777","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,30]]},"assertion":[{"value":"2023-09-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}