Functional Assessment of the Hautmann Ileal Neobladder with Chimney Modification Using Uroflowmetry and a Questionnaire

Abstract

Urinary diversion reconstruction is essential after radical cystectomy and neobladder reconstruction is accepted as a fine option. This study included 51 patients, who underwent radical cystectomy with orthotopic neobladder reconstruction by a Hautmann ileal neobladder with chimney modification from 2006 to 2014. Functional outcomes were evaluated using a questionnaire and uroflowmetry. Perioperative complications were analyzed retrospectively. The mean follow-up period was 36.1 months. Eighty-six percent of patients voided without clean intermittent catheterization (CIC) assistance. CIC was used 1-2x per day or every time they voided in 8% and 6% of patients, respectively, and 71% of patients were continent. The percentages of patients who used 1, 2, 3-4, and ≥5 pads per day were 15%, 6%, 2%, and 6%, respectively. Daytime and nighttime continence were achieved in 86% and 69% of patients, respectively. Daily mucus leakage was reported in 69% of patients. The mean maximum neobladder capacity, voided volume, postvoid residual volume, and maximum flow rate were 413.2 mL, 370.6 mL, 43.7 mL, and 20.8 mL/s, respectively. Eighteen early and 5 late complications developed in 13 and 5 patients, respectively. Reoperations were needed in 7 patients. The Hautmann ileal neobladder with chimney modification provided satisfactory results regarding functional outcomes.

Othotopic ileal neobladder “Belgrade pouch” in females

“…The most common early complications of such kind of surgical procedure in other studies were ileus (up to 15%) and wound infection (up to 12%) 10 . In this study, there was only one patient with paralytic ileus and there was no report of any wound infection and dehiscence, but our results are probably influenced by a smaller number of patients.…”

Energy Homeostasis of the Artificial Bladder in Experimental Conditions

“…The intestine transplant has the properties of resorption of urine components with the development of hyperchloremic acidosis, possibly urodynamic disorders of the upper urinary tract and the progression of renal failure, which complicates the course of the long-term postoperative period in the initially severe and age-related contingent of patients [7,8]. Metabolic acidosis develops in 15 % of patients with a formed conduit, in 50 % of patients with intestinal reservoir from the ileum, and in 80-100 % of patients with a reservoir of the large intestine [9].…”