Orthotopic ileal neobladder: the influence of reservoir volume and configuration on urinary continence and emptying properties

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dc.contributor.authorNesrallah, Luciano João [UNIFESP]
dc.contributor.authorSrougi, Miguel [UNIFESP]
dc.contributor.authorDall'Oglio, Marcos Francisco [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.date.accessioned2016-01-24T12:34:15Z
dc.date.available2016-01-24T12:34:15Z
dc.date.issued2004-02-01
dc.description.abstractOBJECTIVETo evaluate the influence of the volume and configuration of the neobladder on urinary continence and reservoir emptying in orthotopic urinary reservoirs using intestinal segments for bladder replacement after radical cystectomy.PATIENTS and METHODSFifty-nine patients who had had a radical cystectomy and urinary reconstruction with an orthotopic ileal neobladder were followed for greater than or equal to 1 year; 27 (group 1) had the ileal neobladder created with a shorter intestinal segment (40 cm) in an elongated shape ('J'), and 32 (group 2) had their reservoir made more spherical with a longer ileal loop (60-65 cm). the rates of urinary continence, enuresis, neobladder capacity and postvoid residual urine were evaluated first at 3-6 months and again 1 year after surgery in both groups.RESULTSAt 3-6 months after surgery urinary incontinence and enuresis were more common in group 1, but at 1 year had the same frequency in both groups, at respectively 11% and 44% in group 1, and 13% and 47% in group 2 (P > 0.05). the neobladder capacity and postvoid residual urine were significantly higher in group 2, at > 600 mL and > 100 mL, respectively, in 14% and 14% of the patients in group 1 and 57% and 52% of those in group 2 (P < 0.05). Urinary retention requiring intermittent catheterization did not occur in group 1 but did in 19% of group 2.CONCLUSIONThe orthotopic spherical ileal neobladder with a large initial volume is apparently not associated with better continence rates and is prone to developing progressive enlargement, which can lead to neobladder atony and progressive emptying failure, increasing the chance of complete urinary retention.en
dc.description.affiliationUniversidade Federal de São Paulo, Div Urol, São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Div Urol, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent375-378
dc.identifierhttp://dx.doi.org/10.1111/j.1464-410X.2003.04620.x
dc.identifier.citationBju International. Oxford: Blackwell Publishing Ltd, v. 93, n. 3, p. 375-378, 2004.
dc.identifier.doi10.1111/j.1464-410X.2003.04620.x
dc.identifier.issn1464-4096
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/27595
dc.identifier.wosWOS:000188810500029
dc.language.isoeng
dc.publisherBlackwell Publishing Ltd
dc.relation.ispartofBju International
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjecturinary reservoiren
dc.subjectorthotopic neobladderen
dc.subjecturinary incontinenceen
dc.subjectoutcomeen
dc.titleOrthotopic ileal neobladder: the influence of reservoir volume and configuration on urinary continence and emptying propertiesen
dc.typeinfo:eu-repo/semantics/article
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