Urodynamic characteristics of the modified orthotopic ileal neobladder

Kosevic, Branko; Aleksić, Predrag; Novák, Miroslav; Bančević, Vladimir; Stamenković, Dušica; Nikolić, Ivica; Milosevic, R.

doi:10.2298/vsp1203253k

Cited by 2 publications

(6 citation statements)

References 16 publications

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“…In our series the patients have a lower continence rate in the first months, which was expected due to a significantly lower capacity. Between the sixth and the twelfth month after the operation the capacity of the Belgrade neobladder exceeds 350 ml and it still records a mild growth which correlates with the constant increase in the daytime continence percentage in this group, even without a major increase of pressure in the neobladder 22 . Considering the fact that the neobladder capacity shall continue to increase over time, we can understand at this point the advantage of creating a neobladder from a shorter ileal segment, which may result in "optimum capacity" and excellent daytime continence 9 -12 months after the operation which may be preserved over time.…”

Section: Resultsmentioning

confidence: 84%

“…According to referent studies, retention more often occurs in womeneven in 25-40% of operated women due to increased mobility of the urethra, whereas the percentage of daytime continence is around 75-90% 21 . A smaller percentage of nighttime continence is recorded in women and according to the results published so far it ranged between 55-66% 22 . In our series one female patient had a urinary catheter that was placed due to incontinence, and there were no female patients that had a catheter placed due to a significant residual urine i.e.…”

Section: Resultsmentioning

confidence: 90%

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Orthotopic ileal neobladder creation according to the original surgical method “Belgrade pouch“ - a ten-years experience

2021

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Background/Aim. The principle of continent urinary derivations is based on the formation of a reservoir as similar as native bladder is, with satisfactory capacity, high level of continence, low pressure and small resorbent surface as possible, to prevent metabolic disorders. Methods. In this prospective and partially retreospective study we included 148 patients with organ confined muscle invasive bladder cancer, operated in ten years period and followed up in 3 years period after radical cystectomy and original surgical technique of creating "U" shaped orthotopic neobladder using a short ileal segment average length of 30 cm called "Belgrade pouch". Results. Results of 126 male and 22 female patients three years following the surgery, showed average pouch capacity 477(330-659) ml, insignificant residual urine 52 (0-92) ml , average five times 24 hrs voiding frequency, day time continence 90% and nigttime continence 88%, with 7% of patients with mild acidosis, and 3% of patients with vitamine B-12 defficiency. Conclusion. Neobladder created according to the "Belgrade Pouch" technique showed excellent results comparabile with standard techinques, with adequate capacity, high continence rate, favourable 24-hrs voiding frequency, insignificant residual urine and significant lower rate of metabolic complications during 3 years of follow up period. Key words: neobladder, short ileal segment, originals surgical technique, complications. Apstrakt Uvod/Cilj. Princip kontinentnih urinarnih derivacija je zasnovan na kreiranju arteficijalnog rezervoara za urin, što sličnijeg mokraćnoj bešici, adekvatnog kapaciteta, visokog stepena kontinencije, niskog pritiska i što manje resorptivne površine kako bi se smanjio procenat metaboličkih komplikacija. Metode. U prospektivnu i delom retrospektivnu studiju uključeno je 148 pacijenata operisanih zbog organ-ograničenog mišićno invazivnog tumora mokraćne bešike u desetogodišnjem periodu, kojima je nakon radikalne cistektomije originalnom hirurškom tehnikom kreirana neobešika od kratkog segmenta ileuma u obliku 4 slova "U", prosečne dužine 30 cm. Period praćenja nakon operacije u ovoj studi je bio tri godine. Rezultati. Analiza rezultata 126 operisanih muškaraca i 22 operisane žene Beogradskom tehnikom kreiranja neobešike nakon tri godine je pokazala prosečnu zapreminu neobešike od 477(330-659) ml, zapreminu rezidualng urina koja je bila klinički beznačajna 52 (0-92) ml , i prosečna frekvencija 24-časovnog mokrenja od pet puta na dan. Dnevnu kontinenciju je imalo 90% operisanih, a noćnu 88%. 7% pacijenata je imalo blagu acidozu, a 3% deficijenciju vitamina B12. Zaključak. Neobešika kreirana po metodi "Belgrade pouch" pokazala je odlične rezultate, uporedive sa standardnim tehnikama obezbedjujući odličan kapacitet, visok stepen kontinencije, dobru 24časovnu frekvenciju mokrenja, beznačajan rezidualni urin I značajno nižu stopu metaboličkih komplikacija u trogodišnjem periodu praćenja. Ključne reči: neobešika, kraći ilealni segment, originalna hirurška tehnika, komplikacije.

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Section: Resultsmentioning

confidence: 84%

Section: Resultsmentioning

confidence: 90%

Orthotopic ileal neobladder creation according to the original surgical method “Belgrade pouch“ - a ten-years experience

2021

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“…The vast majority of articles included in our SR were retrospective, with only a few (28.8%) prospective trials [8,12,13,15,[21][22][23]25,33,46,48,49,53,60,[63][64][65]. Only 13 (22%) report institutional review board approval [8,[13][14][15][20][21][22]25,33,40,53,64,65].…”

Section: General Aspectsmentioning

confidence: 99%

“…Comorbidities were reported in eight studies [7,8,13,30,37,53,64,65]. Time of follow-up is reported in 44 (74.6%) studies, but in 15 (23.4%) studies, this data is lacking [7,9,19,23,32,36,39,41,43,46,48,51,53,60,61]. Follow-up ranges from a minimum of 5 months [35] to 179.2 months [31], for a mean value of 42.7 months and a median value of 32.9 (25-75th percentile: 19 to 60.5 months).…”

Section: General Aspectsmentioning

confidence: 99%

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Urodynamic Parameters and Continence Outcomes in Asymptomatic Patients with Ileal Orthotopic Neobladder: A Systematic Review and Metanalysis

Asimakopoulos,

Finazzi Agrò,

Piechaud

et al. 2024

Cancers

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Introduction: The orthotopic neobladder is the type of urinary diversion (UD) that most closely resembles the original bladder. However, in the literature the urodynamic aspects are scarcely analysed. Objective: To provide the first systematic review (SR) on the urodynamic (UDS) outcomes of the ileal orthotopic neobladders (ONB). Continence outcomes are also presented. Methods: A PubMed, Embase and Cochrane CENTRAL search for peer-reviewed studies on ONB published between January 2001–December 2022 was performed according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. Results and Conclusion: Fifty-nine manuscripts were eligible for inclusion in this SR. A great heterogeneity of data was encountered. Concerning UDS parameters, the pooled mean was 406.2 mL (95% CI: 378.9–433.4 mL) for maximal (entero)cystometric capacity (MCC) and 21.4 cmH2O (95% CI: 17.5–25.4 cmH2O) for Pressure ONB at MCC. Postvoid-residual ranged between 4.9 and 101.6 mL. The 12-mo rates of day and night-time continence were 84.2% (95% CI: 78.7–89.1%) and 61.7% (95% CI: 51.9–71.1%), respectively.Despite data heterogeneity, the ileal ONB seems to guarantee UDS parameters that resemble those of the native bladder. Although acceptable rates of daytime continence are reported the issue of high rates of night-time incontinence remains unsolved. Adequately designed prospective trials adopting standardised postoperative care, terminology and methods of outcome evaluation as well as of conduction of the UDS in the setting of ONB are necessary to obtain homogeneous follow-up data and to establish UDS guidelines for this setting.

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Urodynamic characteristics of the modified orthotopic ileal neobladder

Abstract: An ileal orthotopic pouch created by a modified technique using a shorter segment of the terminal ileum after 12 months presents with urodynamic characteristics similar to the native bladder.

Cited by 2 publications

References 16 publications

Orthotopic ileal neobladder creation according to the original surgical method “Belgrade pouch“ - a ten-years experience

Orthotopic ileal neobladder creation according to the original surgical method “Belgrade pouch“ - a ten-years experience

Urodynamic Parameters and Continence Outcomes in Asymptomatic Patients with Ileal Orthotopic Neobladder: A Systematic Review and Metanalysis

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