Experience with Various Types of Orthotopic Neobladder in Japanese Men: Long-Term Follow-Up

Abstract

Introduction: The objective of this study was to review the long-term outcomes of orthotopic neobladder (NB) creation. Materials and Methods: This study included 235 Japanese men who underwent NB reconstruction after radical cystectomy and were followed for at least 3 years. The types of NB used in this series were Studer, Reddy, Hautmann and Mainz NB in 136, 51, 32 and 16, respectively. Results: Early and late complications occurred in 70 and 33 men, respectively. Of the 235 men, 210 could void spontaneously, and day- and nighttime continence were achieved in 189 and 149, respectively. The mean maximal flow rate, voided volume and post-void residual were 15.9 ml/s, 209.6 and 38.0 ml, respectively. SF-36 survey for postoperative quality of life showed no significant differences in 7 of the 8 scale scores between the 235 men and an age-matched control population in Japan. The 5-year overall and cancer-specific survival rates were 71.2 and 75.7%, respectively. There were no significant differences in any parameters examined among the four groups except for post-void residual, which was significantly smaller in the Reddy group than in the other three groups. Conclusion: The orthotopic NB could generally provide satisfactory outcomes on long-term follow-up, irrespective of the types of NB.