Editorial Comment to Use of sigmoid colon in orthotopic neobladder reconstruction: Long‐term results

Abstract

Editorial Comment Editorial Comment to Use of sigmoid colon in orthotopic neobladder reconstruction: Long-term resultsIn this issue of the International Journal of Urology, Nicita et al. presented their experience regarding sigmoid neobladder reconstruction and its long-term functional outcome. 1 They observed that neobladder continence and capacity significantly improved over the first 5 years, the patients remained stable over the long term, and the renal function was well preserved. Various different procedures for orthotopic reconstruction have already been described, such as Kock pouch, Studer neobladder and Hautmann ileal neobladder. As the authors commented, the selection would be largely up to each surgeon's preference. Because the number of 160 patients was relatively large, they provided further information regarding the long-term stability of sigmoid neobladder in addition to pre-existing studies. 2,3Furthermore, they reported a low early complication rate of 22.6% compared with previous studies, although they did not provide the details of postoperative management. 4,5 Regarding the continence rate, they observed 45% complete continence (daytime and night-time), and 36% daytime continence only. Because "daytime continence only" probably means daytime continence + night-time incontinence, approximately 80% of patients would have "daytime continence," being consistent with previous observations. 2 As described above, although they also described the durability of sigmoid neobladder, long-term follow up would be mandatory in terms of cancer control, the functional status of the pouch and renal function. For example, pouch perforation is one of the late life-threatening complications.