Long-term urodynamic and functional analysis of orthotopic “W” ileal neobladder following radical cystectomy

Marim, G.; Bal, Kaan; Balcı, Uğur; Girgin, Cengiz; Dinçel, Çetin

doi:10.1007/s11255-007-9294-7

Cited by 18 publications

(19 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These results are very similar to those previously reported by other authors, who constructed different types of neobladder (19,20). However, it must be emphasized that other studies had reported superior functional bladder capacity at the end of the first year (21). In these studies absorbable sutures were used, and this fact makes us to suggest that staplers line may restrain bladder functional capacity during the first years.…”

Section: Discussionsupporting

confidence: 90%

605 Radical cystectomy with W-shaped orthotopic ileal neobladder constructed with non-absorbable titanium staples – long term follow-up

Kravchick¹,

Lobic²,

Paz³

et al. 2012

European Urology Supplements

View full text Add to dashboard Cite

Purposes:We retrospectively assessed our experience with the W-shaped orthotopic ileal pouch, which was constructed with non -absorbable titanium staples. For these purpose, we discuss the results of bladder capacity, urinary continence and early and long-term postoperative complications. Materials and Methods:We included in the study 17 patients who underwent radical cystoprostatectomy followed by construction of an orthotopic W-shaped ileal pouch between October 2000 and November 2009. A 65-70 cm segment of ileum was isolated and prearranged into a W-configuration, leaving two 10 cm intact segments on both sides of the ileal fragment. In our technique we entirely anatomized all adjacent limbs in order to create a sphere-shaped pouch. The ureters were directly anastomized to both intact segments of the ileal division. All our patients underwent pouchscopy 6 months after operation and annually. Results: Mean operative time for neobladder reconstruction and ureteral anastomoses was 87 ± 7.67 minutes. In one patient a leak from the ileo-ileal anastomosis was confirmed on the 3rd day after operation. In 2 cases unilateral stricture of the ureteral-neobladder anastomosis was documented. Staple lines were mostly covered with ileal mucosa after 6 months. The mean functional bladder capacity was 340 ± 27.6 mL and 375 ± 43.4 mL at 6 and 12 months, respectively. First-year daytime and nighttime continence was good and acceptable in 90% and 78% of patients, while it increased to 95% during the 2nd year. Conclusions: The long term follow-up shows that non-absorbable titanium staples can be safely used for creation of an orthotopic ileal neobladder. However, these data should be further validated in a larger series of patients.

show abstract

Section: Discussionsupporting

confidence: 90%

605 Radical cystectomy with W-shaped orthotopic ileal neobladder constructed with non-absorbable titanium staples – long term follow-up

Kravchick¹,

Lobic²,

Paz³

et al. 2012

European Urology Supplements

View full text Add to dashboard Cite

show abstract

“…It is known that daytime stress incontinence may arise from reduced urethral outlet resistance in combination with low neobladder capacity, reduced compliance, or elevated neobladder pressure [7][8][9][10] . However, similar urodynamic results can be demonstrated for the W-shaped neobladder compared to naive bladder [11] and it remains unclear why some neobladder patients show daytime SUI despite a good sphincter function and a W-shaped pouch. A possible correlation between SUI and the position of the neobladder has been suggested.…”

Section: Discussionmentioning

confidence: 83%

Real-Time MRI of Continent and Stress Incontinent Male Patients after Orthotopic Ileal Neobladder

et al. 2011

View full text Add to dashboard Cite

Introduction: The aim of this study was to correlate anatomic differences with continence status in male patients after cystoprostatectomy and ileal neobladder using real-time magnetic resonance imaging. Patients and Methods: Anatomic differences of 14 male patients (7 daytime continent and 7 stress incontinent) with ileal neobladder were determined by measuring the orthogonal distance of the bladder neck to the pubococcygeal line (PCL) to correlate anatomic differences with continence status. Results: The median distance of the bladder neck to PCL was +5.4 mm in continent patients before voiding whereas in incontinent patients it was +2 mm (p = 0.012). During the Valsalva maneuver, the median distance in continent patients was +4 and in incontinent patients –3 mm (p = 0.003). At the end of micturition, the median distance was +2.3 mm in continent patients and –12 mm in incontinent patients (p = 0.002). Conclusions: The bladder neck in incontinent patients showed more pronounced mobility in relation to the PCL during micturition and the Valsalva maneuver as compared to continent patients. In addition, the ileal neobladder was positioned significantly lower in the pelvis of incontinent patients. These preliminary results suggest that a stable bladder neck may be an important factor to reach full continence in patients with ileal neobladder.

show abstract

“…Marim et al evaluated the functional results of 20 orthotopic “W” ileal NBs, and the mean NB capacity and PVR were 584.7 mL and 83.5 mL, respectively. In addition, 85% of patients had complete daytime incontinence [6]. In another study, Miyake et al reported that the mean maximum flow rate, voided volume, and postvoid residual volume of 82 orthotopic sigmoid NBs were 18.6 mL/s, 345.3 mL, and 24.5 mL, respectively [7].…”

Section: Discussionmentioning

confidence: 99%

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

Lee

Jung

Choi

et al. 2016

BioMed Research International

View full text Add to dashboard Cite

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.

show abstract

Long-term urodynamic and functional analysis of orthotopic “W” ileal neobladder following radical cystectomy

Cited by 18 publications

References 19 publications

605 Radical cystectomy with W-shaped orthotopic ileal neobladder constructed with non-absorbable titanium staples – long term follow-up

605 Radical cystectomy with W-shaped orthotopic ileal neobladder constructed with non-absorbable titanium staples – long term follow-up

Real-Time MRI of Continent and Stress Incontinent Male Patients after Orthotopic Ileal Neobladder

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

Contact Info

Product

Resources

About