Indications Operative techniqueStandard cystoprostatectomy is carried out via a trans-Globally, radical cystoprostatectomy represents the most common form of curative treatment for invasive bladder peritoneal approach. In the present patients, the lymph nodes were analysed using frozen sections and if positive, cancer. The loss of the normal urinary reservoir creates the problem of finding an acceptable form of urinary a cutaneous ileal conduit was fashioned. Particular attention is paid to haemostasis of the dorsal diversion; where the urethra can be preserved and follow-up is assured, the formation of an orthotopic venous complex; damage to the periurethral muscles at the time of urethral section is avoided. After section of neobladder arguably provides the best functional result, culminating in a patient who voids urethrally and has the urethra two stay-sutures are placed at the 3 and 9 o'clock positions in the urethra. The sigmoid is then acceptable continence. To this end, almost every part of the alimentary tract has been used, although the ileum, mobilized and inspected; at this point it must be ascertained that the sigmoid loop is long enough to reach the caecum and sigmoid appear to be the most common. The various techniques for neovesical construction also urethral margin without tension (in practice, this is nearly always the case) and that there is no inflamma-vary in their complexity and ease of execution, but common to all is the necessity to have a reservoir tory disease of the sigmoid. Having freed the mesosigmoid, the sigmoid is divided transversely to give a of adequate capacity and stability. Arguably of less importance in patients with cancer (who tend to be U-shaped loop 35-40 cm long. Single-stage colonic anastomosis is carried out according to the usual practice elderly and with a limited 5-year survival) is the question of long-term malignant transformation of the reservoir, (we use two layers of continuous polydioxanone sutures, PDS). Next, the sigmoid neobladder is fashioned using or late metabolic complications arising from the removal of intestinal segments. the following steps. With a diathermy knife, the sigmoid is detubularized by incision along the most anterior of We describe the formation of a detubularized sigmoid neobladder with a simplified neovesico-urethral anasto-the taenia coli (Fig. 1b). With a continuous suture (PDS 4/0) the internal edges of the sigmoid are brought mosis. The technique is simple to learn, gives good results and uses a segment of bowel whose loss appears together, giving a posterior plaque. The ureters are reimplanted using an antireflux submucosal tunnel. The to be of limited functional importance.ureters can easily be brought through the mesosigmoid; a tunnel of around 4 cm is the aim and this is con-Method veniently made by scissors dissection. The ureters are sewn in place with interrupted 5/0 PDS over ureteric The technique was used in 15 patients in whom primary cystoprostatectomy was carried out for invasive TCC of catheters (Fig. 1b). The neovesi...
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