Three-Dimensional Computed Tomography of the Orthotopic Ileal Neobladder Reconstruction: Normal and Abnormal Findings

Sassi, Claudia; Santilli, Ludovica; Concetti, Sergio; Schiavina, Riccardo; Amadori, Elena; Severini, E.; Martorana, Giuseppe; Battista, Giuseppe

doi:10.1159/000209362

Cited by 6 publications

(2 citation statements)

References 33 publications

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“…However, it must be considered that the positive conclusions of all reported studies overlap, and this fact supports the use of UDM and of VUDM in the assessment of orthotopic ileal neobladders. Specifically, the simultaneous morphological and functional evaluation provided b y V U D M ( wh e n n e c e s s a r y , al s o c o m b i n e d wi t h neurophysiological tests such as perineal/external sphincter electromyography) cannot be reproduced by other imaging techniques, including also three-dimensional CT that has been applied only in some preliminary experiences (55). The examination of the manuscripts reviewed in this report shows that the management of patients with orthotopic ileal neobladder must be carried out by expert teams belonging to centers with high surgical volume.…”

Section: Discussionmentioning

confidence: 99%

Urodynamic assessment of orthotopic urinary diversions

Palleschi

Cardi²,

Falsaperla³

2022

Front. Urol.

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Orthotopic neobladder represents the best option for bladder reconstruction in terms of body image preservation and postoperative QoL for patients submitted to radical cystectomy. This technique offers also good short-term and logn-term functional outcomes. Nowadays, ileal orthotopic neobladder is the the bladder reconstruction of choice for both sexes of because there is large evidence of its superiority respect to other techniques in terms of surgical and functional results. Complications may develop during the follow-up, therefore clinical and instrumental adequate assessment is mandatory to early recognize alterations of neobladder function thus to prevent damages to the reservoir itself and to the kidney function, which can affect patients’ quality of life. Literature has shown that urodynamics and videourodynamics have significantly contributed to assess the functional aspects of ileal neobladders since the beginning of their use in patients submitted radical cystectomy, helping surgeons to improve the technical aspects of the procedure. After the preliminary results, many groups have observed that urodynamics and videourodynamics are the best tools to evaluate morphology and function of ileal neobladders. These diagnostic methods help to correctly diagnose the cause of altered neobladder function simultaneously providing anatomical informations that can be related to clinical signs and symptoms. Recent studies have confirmed the usefullness of these instruments also in patients with ileal neobladder achieved by laparoscopic and robotic approach, confirming the higher diagnostic value also respect to modern imaging techniques, as three dimensional computed tomography and magnetic resonance.

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Section: Discussionmentioning

confidence: 99%

Urodynamic assessment of orthotopic urinary diversions

Palleschi

Cardi²,

Falsaperla³

2022

Front. Urol.

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“…Postoperative imaging studies are established for the evaluation of postsurgical complications and follow-up [12][13][14][15] . Several imaging studies used computed tomography and static MRI to evaluate postoperative anatomy and functional aspects of the neobladder [9,[15][16][17][18] .…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2011

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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.

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