Experience with the orthotopic ileal neobladder in women: a mid-term follow-up

Experience with the orthotopic ileal neobladder in women: a mid-term follow-up

Author Nesrallah, Luciano João Autor UNIFESP Google Scholar
Almeida, Fernando Gonçalves Autor UNIFESP Google Scholar
Dall'Oglio, Marcos Francisco Autor UNIFESP Google Scholar
Nesrallah, Adriano João Autor UNIFESP Google Scholar
Srougi, Miguel Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Beneficent Portuguese Hosp
Abstract OBJECTIVETo report our experience with orthotopic bladder reconstruction in women, as currently the ileal orthotopic neobladder is the diversion of choice for women requiring a bladder substitute at our institution.PATIENTS and METHODSFrom February 1995 to March 2001, 29 women with muscle-invasive bladder carcinoma underwent a nerve-sparing radical cystectomy and had an orthotopic ileal neobladder reconstructed. the outcome was evaluated at 2 and 6 months and then yearly, by a clinical history, physical examination, voiding diary, stress test and estimate of functional neobladder capacity.RESULTSAll patients were followed for at least 14 months (mean 27.5); there were no major complications related to the surgery. the mean (range) neobladder capacity 2 months after surgery was 250 (190-320) mL; at 6 months it increased, remaining stable for the remaining follow-up, at 450 (350-700) mL. Four patients (14%) had nocturnal incontinence and one stress urinary incontinence, associated with using three pads per day. Three patients (10%) required catheterization for a postvoid urinary residual of > 100 mL. of the 29 patients, seven died with metastatic disease and three from causes unrelated to the reservoir or bladder cancer. Currently, 19 patients (65%) are alive and disease-free, with a mean follow-up of 35 months.CONCLUSIONOrthotopic neobladder reconstruction in women, using 40 cm of ileum, is safe and gives high continence and low urinary retention rates. Therefore, it should be advised as the first option in women with good renal function and a tumour-free bladder neck.
Keywords bladder
cystectomy
urinary diversion
continent
women
Language English
Date 2005-05-01
Published in Bju International. Oxford: Blackwell Publishing Ltd, v. 95, n. 7, p. 1045-1047, 2005.
ISSN 1464-4096 (Sherpa/Romeo, impact factor)
Publisher Blackwell Publishing Ltd
Extent 1045-1047
Origin http://dx.doi.org/10.1111/j.1464-410X.2005.05463.x
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000228397500028
URI http://repositorio.unifesp.br/handle/11600/28264

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