Orthotopic neobladder reconstruction

Abstract

Orthotopic neobladder reconstruction is becoming an increasingly common urinary diversion following cystectomy for bladder cancer. This is in recognition of the potential benefits of neobladder surgery over creation of an ileal conduit related to quality of life (QoL), such as avoiding the need to form a stoma with its cosmetic, psychological and other potential complications. The PubMed database was searched using relevant search terms for articles published electronically between January 1994 and April 2014. Full-text articles in English or with English translation were assessed for relevance to the topic before being included in the review. Patients with neobladders have comparable or better post-operative sexual function than those with ileal conduits. They also have comparable QoL to those with ileal conduits. Orthotopic neobladder is a good alternative to ileal conduit in suitable patients who do not want a stoma and are motivated to comply with neobladder training. However, the selection of a neobladder as the urinary diversion of choice requires that patients have good renal and liver functions and are likely to be compliant with neobladder training. With benefits also come potential risks of neobladder formation. These include electrolyte abnormalities and nocturnal incontinence. This short review highlights current aspects of neobladder formation and its potential advantages.

Sozialmedizinische Begutachtung nach kurativer und adjuvanter Therapie des Harnblasenkarzinoms

“…Eine postoperative Belastungsharninkontinenz nach Neoblasenanlage bedarf der konsequenten rehabilitativ-urologischen Behandlung [16]. Die Prognose ist bei einer entsprechenden multimodularen Rehabilitation auf der Basis einer kontinenzfördernden Krankengymnastik (Neoblasentraining) in Kombination mit einem individuellen Trink-und Miktionsmanagement positiv [17,18].…”

Comparison of postoperative acute kidney injury between ileal conduit and neobladder urinary diversions after radical cystectomy

“…However, bowel conduits have some disadvantages, such as external ostomy-associated negative body image, stomal stenosis, and parastomal hernia. [ 14 , 15 ] Thus, the neobladder technique was reintroduced in 1979, [ 16 ] and other investigators have improved this technique. [ 17 ] A technique that would offer the greatest advantage would be one that has no external devices for urination and preserves anatomical voiding.…”

Structural and Functional Transformation of the Small Intestine Wall in the Conditions of the Functioning of the Artificial Urinary Reservoir in the Experiment

“…Bladder disease with loss of reservoir capacity and function, damage by the tumor process, as well as the complication of specific and non-specific inflammatory diseases requiring its complete removal or resection, led to rapid development of reconstructive surgery of bladder [4,7,8,20]. The main material for restoring the functional capabilities of the bladder (accumulative and evacuator) are different sections of the gastrointestinal tract [3,5,15].…”