TY - JOUR
T1 - Orthotopic ileal neobladder in male patients
T2 - Functional outcomes of 66 cases
AU - Arai, Yoichi
AU - Taki, Yoji
AU - Kawase, Norio
AU - Terachi, Toshiro
AU - Kakehi, Yoshiyuki
AU - Okada, Takuya
AU - Okabe, Tatsushiro
AU - Kanba, Tomomi
AU - Konami, Teruo
AU - Kin, Sojun
AU - Oishi, Kenji
AU - Miyakawa, Mieko
AU - Takeuchi, Hideo
AU - Ueda, Tomohiro
AU - Hamaguchi, Akikazu
AU - Okada, Yusaku
PY - 1999
Y1 - 1999
N2 - 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.
AB - 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.
KW - Neobladder
KW - Urinary diversion
KW - Voiding function
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U2 - 10.1046/j.1442-2042.1999.00084.x
DO - 10.1046/j.1442-2042.1999.00084.x
M3 - Article
C2 - 10466450
AN - SCOPUS:0032819653
VL - 6
SP - 388
EP - 392
JO - International Journal of Urology
JF - International Journal of Urology
SN - 0919-8172
IS - 8
ER -