PURPOSE: Orthotopic bladder substitution following cystectomy in women has recently been introduced at some specialized centers. Studies of such a procedure should consider the oncological and functional outcomes. We analyzed only the functional results of orthotopic bladder substitution since followup is too short (about 2 years) for a valid oncological assessment. MATERIALS AND METHODS: From October 1994 to November 1997, 60 women with a mean age of 48.3 years underwent standard radical cystectomy and orthotopic diversion (ileal W-neobladder with subserous tunnel in 47 and hemi-Kock reservoir in 13). The oncological criterion was organ confined invasive bladder cancer. RESULTS: There was no perioperative mortality. Postoperative complications included fatal pulmonary embolism in 1 woman, deep vein thrombosis in 2, prolonged ileus in 1 and fistula of the vaginal pouch in 3, which was repaired successfully. Cancer recurred in the pelvis in 2 cases and as distant metastases in 5. Of the patients 43 had been followed for a mean of 20.2 months (range 6 to 36), and 32 were continent day and night, 1 was totally incontinent, 2 had daytime stress incontinence and 6 had nighttime incontinence. Six women had difficulty emptying the pouch spontaneously with concomitant residual urine due to acute angulation between the urethra and pouch. CONCLUSIONS: Orthotopic bladder substitution after standard radical cystectomy in select women provides a satisfactory functional outcome. Failure of complete emptying seems to be due to anatomical rather than functional reasons.
PURPOSE: Orthotopic bladder substitution following cystectomy in women has recently been introduced at some specialized centers. Studies of such a procedure should consider the oncological and functional outcomes. We analyzed only the functional results of orthotopic bladder substitution since followup is too short (about 2 years) for a valid oncological assessment. MATERIALS AND METHODS: From October 1994 to November 1997, 60 women with a mean age of 48.3 years underwent standard radical cystectomy and orthotopic diversion (ileal W-neobladder with subserous tunnel in 47 and hemi-Kock reservoir in 13). The oncological criterion was organ confined invasive bladder cancer. RESULTS: There was no perioperative mortality. Postoperative complications included fatal pulmonary embolism in 1 woman, deep vein thrombosis in 2, prolonged ileus in 1 and fistula of the vaginal pouch in 3, which was repaired successfully. Cancer recurred in the pelvis in 2 cases and as distant metastases in 5. Of the patients 43 had been followed for a mean of 20.2 months (range 6 to 36), and 32 were continent day and night, 1 was totally incontinent, 2 had daytime stress incontinence and 6 had nighttime incontinence. Six women had difficulty emptying the pouch spontaneously with concomitant residual urine due to acute angulation between the urethra and pouch. CONCLUSIONS: Orthotopic bladder substitution after standard radical cystectomy in select women provides a satisfactory functional outcome. Failure of complete emptying seems to be due to anatomical rather than functional reasons.
Authors: Andrea B Apolo; Vanessa Hoffman; Matthew G Kaag; David M Latini; Cheryl T Lee; Jonathan E Rosenberg; Margaret Knowles; Dan Theodorescu; Bogdan A Czerniak; Jason A Efstathiou; Matthew L Albert; Srikala S Sridhar; Vitaly Margulis; Surena F Matin; Matthew D Galsky; Donna Hansel; Ashish M Kamat; Thomas W Flaig; Angela B Smith; Edward Messing; Diane Zipursky Quale; Yair Lotan Journal: Urol Oncol Date: 2014-07-25 Impact factor: 3.498
Authors: Richard E Hautmann; Bjoern G Volkmer; Martin C Schumacher; Juergen E Gschwend; Urs E Studer Journal: World J Urol Date: 2006-07-08 Impact factor: 4.226
Authors: Florian Jentzmik; Andres J Schrader; Robert de Petriconi; Robert Hefty; Johannes Mueller; Johannes Doetterl; Alexander Eickhoff; Mark Schrader Journal: World J Urol Date: 2012-02-10 Impact factor: 4.226