Voiding function of orthotopic ileal neobladder in women

Arai, Yoichi; Okubo, Kazutoshi; T, Konami; Kin, Sojun; Kanba, Tomomi; Okabe, Tatsushiro; Hamaguchi, Akikazu; Okada, Yusaku

doi:10.1016/s0090-4295(99)00027-8

Cited by 27 publications

(19 citation statements)

References 14 publications

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“…The preservation of external urethral sphincter by sectioning the urethra 0.5-1 cm distally to the bladder neck allows maintenance of urinary continence without compromising oncological principles. Aria et al [7] reported 83.35% excellent day time continence and up to 50% nighttime incontinence despite regular voiding during the night [7]. Women are more continent because of the limited dissection performed anterior to urethra along the pelvic floor.…”

Section: Discussionmentioning

confidence: 99%

“…It should not result into intestinal malabsorption, fluid and electrolyte imbalance as well as the metabolic disorder. The advantages of ONB are, (i) orthotopic position of bladder resembling the original bladder in location and function, providing the most physiological form of voiding, (ii) maintenance of self-image, (iii) maintenance of interpersonal relationships and, (iv) the QOL is preserved to a higher degree than ileal conduit urinary diversion [5][6][7]. The patient voids with the relaxation of the pelvic floor muscles and valsulva maneuver.…”

Section: Discussionmentioning

confidence: 99%

“…The development of the orthotopic neobladder (ONB) is a recent effort to return the body to the most natural structure and function. With proper selection, at least 75-90% of the patients undergoing cystectomy may be considered appropriate for ONB [7,8].…”

Section: Introductionmentioning

confidence: 99%

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National survey on orthotopic neobladder

2006

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Ileal conduit still remains the urinary diversion of choice following radical cystectomy for muscle invasive carcinoma of the bladder among most of the urologists in India. Orthotopic neobladder reconstruction is practiced only in selected centres. Wound infection, urinary leak and obstruction at ureterointestinal anastomosis are the main complications. Clean intermittent cathaterisation is required at an average of 50% of the patients to ensure complete emptying of the neobladder.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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National survey on orthotopic neobladder

2006

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“…However, how to surgically ensure a funnel–shaped outlet at the voiding site remains unknown. Arai et al [17]also identified urethral angulation as a main mechanisms of voiding dysfunction. In our study, the distance from neobladder outlet to the tail of coccyx was measured.…”

Section: Discussionmentioning

confidence: 99%

Voiding Dysfunction of Sigmoid Neobladder in Women: A Comparative Study with Men

Fujisawa

Isotani²,

Gotoh³

et al. 2001

Eur Urol

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“…De hecho, el uso de prensa abdominal importante puede ser consecuencia de una obstrucción que debe ser investigada. La disfunción miccional que conduce a retención urinaria se ha observado con mayor frecuencia en mujeres 30,31 .…”

Section: Función Eréctilunclassified

Manejo perioperatorio y resultados en pacientes con neovejiga ileal ortotópica: Postoperative management and results

Ardura¹,

Abarca²,

Studer

2008

Actas Urol Esp

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RESUMENMANEJO PERIOPERATORIO Y RESULTADOS EN PACIENTES CON NEOVEJIGA ILEAL ORTOTÓPICA La reconstrucción del tracto urinario tras la cistectomía radical ha evolucionado desde la simple derivación urinaria hasta la reconstrucción anatómica y funcional del mismo lo más próxima posible al estado preoperatorio del paciente. En los últimos 20 años, la reconstrucción ortotópica ha pasado de cirugía experimental a ser el método preferido de derivación urinaria en ambos sexos. Los urólogos que realizan este tipo de intervención deben tener experiencia en cirugía pélvica y ser capaces de realizar una cistectomía con preservación nerviosa. Sin embargo, lo más importante en estos enfermos es el manejo postoperatorio, para lo cual se requiere un profundo conocimiento de la fisiología de la neovejiga, sus posibles complicaciones y tratamientos. Revisamos en este artículo los principales aspectos del manejo postoperatorio de los pacientes con neovejiga ileal. También se revisan los resultados de la técnica a largo plazo con respecto a continencia, función sexual, preservación de función renal, control oncológico y calidad de vida de los pacientes. ABSTRACT ORTHOTOPIC ILEAL NEOBLADDER. POSTOPERATIVE MANAGEMENT AND RESULTSUrinary diversion after cystectomy have evolved from simple diversion and protection of the upper tracts to functional and anatomic restoration as close as possible to the natural preoperative state. Over the past 15 years, orthotopic reconstruction has evolved from "experimental surgery" to the "preferred method of urinary diversion" in both sexes. Urologist that perform this technique should have an appropriate experience with pelvic surgery and be able to perform a nerve sparing radical cystectomy. Nevertheless, the postoperative management of these patients is more important than the surgical construction if good longterm results are to be achieved. For this reason, a great knowledge about the neobladder´s physiology, postoperative complications and their treatment are needed. We review the most important aspects in the postoperative management of patients with ileal neobladder. We also resume the long term outcomes concerning to continence, sexual function, renal impairment, oncologic safety and quality of life.

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Voiding function of orthotopic ileal neobladder in women

Cited by 27 publications

References 14 publications

National survey on orthotopic neobladder

National survey on orthotopic neobladder

Voiding Dysfunction of Sigmoid Neobladder in Women: A Comparative Study with Men

Manejo perioperatorio y resultados en pacientes con neovejiga ileal ortotópica: Postoperative management and results

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