Ileal conduit (IC) is the most common modality for urinary diversion after radical cystectomy for bladder cancer worldwide. In benign conditions with lower urinary tract dysfunction, it is considered the last resort after failure of conservative and minimally invasive approaches. We aimed to evaluate indications and complications of IC done for benign diseases in our unit in a 10-year period.

Retrospective data was collected for Open IC performed for benign conditions between 2014 and 2023. Patient demographics, co-morbidities, indications, duration of hospital stay, perioperative complications were analyzed.

59 patients (Male: 25, Female: 34; mean age: 58.7 years) were included. 
The most common indication was bladder pain syndrome (n=20, 33.8%) followed by neuropathic lower urinary tract dysfunction (NLUTD) and revision of previous diversion types: 10 cases each (16.9% each). Other indications include persistent non-neurogenic urinary incontinence in 4 cases, ketamine cystopathy in 3 cases. 
IC was preceded with simple cystectomy in 25 females and cysto-prostatectomy in 20 males (total cystectomy cases of 47, 79.6%). The histology of these bladders revealed picture of chronic inflammation only with no evidence of malignancy in 40 (88.88%). The rest of the patients showed squamous metaplasia in 5 (11.11%). 25% (5 out of 20) of all male patients showed histological evidence of prostate cancer in their prostates after simple cysto-prostatectomy.
38 patients (64.4%) did not show any significant post-operative complications. Post-operative paralytic ileus was recorded in 4, wound complications in 6, and bowel leak in 2 cases. The most common long term complications (after 6 months) were recurrent UTI (10%) and stoma related complications (10%) (6 cases each). Ureteric stricture occurred in 3 cases and pyocystis was recorded in 3/14  of the non-cystectomy cohort.

- Prospective data analysis is advisable in future cases
- QOL assessment by a validated questionnaire is essential in the assessment of these cases 
- Complications are more with co-morbid and neuropathic patients

Open IC diversion is  a valid option for benign conditions and can achieve good long term results with acceptable complication rates in experienced hands. Our data suggests that simultaneous cystectomy/cysto-prostatectomy should be considered whenever possible. Open IC diversion is  a valid option for benign conditions and can achieve good long term results with acceptable complication rates in experienced hands. Our data suggests that simultaneous cystectomy/cysto-prostatectomy should be considered whenever possible.