Orthotopic ileal neobladder in male patients: Functional outcomes of 66 cases

Yoichi Arai, Yoji Taki, Norio Kawase, Toshiro Terachi, Yoshiyuki Kakehi, Takuya Okada, Tatsushiro Okabe, Tomomi Kanba, Teruo Konami, Sojun Kin, Kenji Oishi, Mieko Miyakawa, Hideo Takeuchi, Tomohiro Ueda, Akikazu Hamaguchi, Yusaku Okada

Research output: Contribution to journalArticlepeer-review

44 Citations (Scopus)

Abstract

Background: Orthotopic urinary diversion has become the preferred form of bladder reconstruction after cystectomy. We report on our experience with 66 male patients undergoing this procedure from November 1990 to February 1998. Methods: A neobladder was constructed using an ileal segment with a Hautmann type bladder. Complications were assessed and subdivided into early and late types. Voiding function was evaluated in terms of voiding pattern and continence. Median follow up was 19.5 (range 3.5-87.7) months. Results: There was one (1.5%) perioperative death. The most frequent pouch-related and unrelated early complications were persistent urine leak (7.6%) and prolonged ileus (16.7%), respectively, the majority of cases of which were managed conservatively. Analysis of late complications revealed 6.2% ureteroileal stenosis and 1.5% urethrointestinal stenosis rates, but no case of bladder stone formation. Of the 61 patients in whom voiding function was evaluable, 95.1% achieved excellent daytime continence, while only 67.2% had night-time continence. With regard to posture at voiding, 23 (37.7%) voided in a sitting position. Three of the patients (4.9%) were unable to void and required regular intermittent catheterization. Conclusions: An orthotopic neobladder can be constructed with acceptable morbidity and excellent functional results. We believe that orthotopic urinary diversion offers an attractive alternative to a bladder substitute when cystectomy is required.

Original languageEnglish
Pages (from-to)388-392
Number of pages5
JournalInternational Journal of Urology
Volume6
Issue number8
DOIs
Publication statusPublished - 1999 Aug 24

Keywords

  • Neobladder
  • Urinary diversion
  • Voiding function

ASJC Scopus subject areas

  • Urology

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