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A total of 1625 patients with colostomy, ileostomy or urostomy, including all members of the Swiss ILCO Association, received a questionnaire concerning their medical, social, family and personal situation. 948 questionnaires were analyzed. The mean age was 64 and the time since operation 6 years. 60% regarded their postoperative instruction in stoma care as adequate, but 32% were unhappy with the preoperative information. The transstomal colonic irrigation technique was still unknown to 21% of the colostomy patients and was utilized by only 32%. One year after the operation 69% of the patients with colostomy, 83% with ileostomy and 59% with urostomy in the under-62 age group were fully reintegrated in their professions. Acceptance of the stoma by family and friends was good and there were no major difficulties in practising sports and other hobbies. Sexuality proved to be the most seriously affected aspect of their personal lives, as 33% male and 13% female patients reported major problems.

Neurogenic bladder in myelomeningocele has been managed until recently by routine ileal conduit urinary diversion. Long-term complications are not uncommon after an ileal conduit and 23 of our patients required major surgical revision during the last 2 years. In 5 patients with an ileal conduit urinary undiversion was performed after excision of the conduit and direct ureteral anastomoses. Over-all progress of these patients has been satisfactory. We conclude that when major surgery is required to correct ileal conduit complications in myelomeningocele, urinary undiversion should be considered in selected cases.