M M Koraitim1, M A Atta, M K Foda. 1. Department of Urology, Faculty of Medicine, University of Alexandria, Egypt.
Abstract
PURPOSE: We studied the volume and pressure changes with time in detubularized and nondetubularized neobladders. MATERIALS AND METHODS: Cystometry was performed at early and late followup in 54 male patients with post-cystectomy intestinal neobladders constructed from an intact ileocecal segment in 33, detubularized sigmoid in 11 and detubularized ileum in 10. RESULTS: With time the capacity of the neobladder increased in all 3 groups. Concomitantly, while intact ileocecal bladders showed an increase in intra-reservoir pressure and persistence of involuntary contractions, detubularized sigmoid and ileal bladders showed a decrease in intra-reservoir pressure and involuntary contractions. CONCLUSIONS: Increased capacity with time is not due to detubularization per se but rather to over distension, which is more marked in detubularized (109 to 112%) than in tubular (79%) segments. Detubularized intestinal neobladders not only offer a high capacity, low pressure and high compliant reservoir but these characteristics also are increased with time.
PURPOSE: We studied the volume and pressure changes with time in detubularized and nondetubularized neobladders. MATERIALS AND METHODS: Cystometry was performed at early and late followup in 54 male patients with post-cystectomy intestinal neobladders constructed from an intact ileocecal segment in 33, detubularized sigmoid in 11 and detubularized ileum in 10. RESULTS: With time the capacity of the neobladder increased in all 3 groups. Concomitantly, while intact ileocecal bladders showed an increase in intra-reservoir pressure and persistence of involuntary contractions, detubularized sigmoid and ileal bladders showed a decrease in intra-reservoir pressure and involuntary contractions. CONCLUSIONS: Increased capacity with time is not due to detubularization per se but rather to over distension, which is more marked in detubularized (109 to 112%) than in tubular (79%) segments. Detubularized intestinal neobladders not only offer a high capacity, low pressure and high compliant reservoir but these characteristics also are increased with time.