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Abstract
Radical cystectomy (RC) with pelvic lymph node dissection (PLND) followed by urinary diversion is the treatment of choice for muscle-invasive bladder cancer (BC) and non-invasive BC refractory to transurethral resection of the bladder (TUR-B) and/or intravesical instillation therapies. Since the morbidity and possible mortality of this surgery are relevant, care must be taken in the preoperative selection of patients for the various organ-sparing procedures (e.g., bladder-sparing, nerve sparing, seminal vesicle sparing) and various types of urinary diversion. The patient's performance status and comorbidities, along with individual tumor characteristics, determine possible surgical steps during RC. This individualized approach to RC in each patient can maximize oncological safety and minimize avoidable side effects, rendering 'standard' cystectomy a surgery of the past.
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Affiliation(s)
- Beat Roth
- Department of Urology, University of Bern, Bern, Switzerland
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Nam JK, Kim TN, Park SW, Lee SD, Chung MK. The Studer orthotopic neobladder: long-term (more than 10 years) functional outcomes, urodynamic features, and complications. Yonsei Med J 2013; 54:690-5. [PMID: 23549816 PMCID: PMC3635617 DOI: 10.3349/ymj.2013.54.3.690] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Revised: 08/04/2012] [Accepted: 08/13/2012] [Indexed: 11/27/2022] Open
Abstract
PURPOSE Radical cystectomy and urinary diversion are the standard treatment for invasive bladder cancer. We analyzed the long-term (>10 years postoperatively) functional outcomes, complications, and urodynamic findings in a single center series of patients who underwent cystectomy and a Studer ileal neobladder substitution. MATERIALS AND METHODS A retrospective chart review of 108 Studer pouches constructed during 1990 and 2011 was performed. Data were analyzed in terms of long-term (>10 years) outcomes. Complications, incontinence, voiding difficulties, upper urinary tract changes, overall satisfaction, and urodynamic findings of the reservoir were obtained. RESULTS We evaluated 19 out of 50 patients who had lived for over 10 years postoperatively. Another 31 patients were not traced: 7 patients died following recurrence, 15 died due to exacerbation of a comorbidity, and 9 patients were lost to follow-up. Concerning complications, 6 patients had an atrophied kidney, 5 patients had moderate hydronephrosis, 5 patients had chronic recurrence of pylelonephritis, and 2 patients had voiding difficulty because of bladder neck stricture due to clean intermittent catheterization. One patient underwent an operation due to intestinal obstruction. Seven patients had incontinence; all 7 patients showed intermittently at night and 2 patients even in waking hours. Maximum bladder capacity was 484.1±119.2 mL, maximum flow rate was 13.6±9.7 mL/sec, and post-void residual urine volume was 146.8±82.7 mL. CONCLUSION Long-term outcomes with the Studer orthotopic ileal neobladder have an acceptable complication rate and good functional results. However, potential adverse outcomes such as renal deterioration, dysfunctional voiding should also be considered.
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Affiliation(s)
- Jong Kil Nam
- Department of Urology, Research Institute for Convergence of Biochemical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Tae Nam Kim
- Department of Urology, Research Institute for Convergence of Biochemical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Sung Woo Park
- Department of Urology, Research Institute for Convergence of Biochemical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Sang Don Lee
- Department of Urology, Research Institute for Convergence of Biochemical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Moon Kee Chung
- Department of Urology, Research Institute for Convergence of Biochemical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
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Destefanis P, Fontana D. Proposta di Follow-Up del Paziente con Neovescica Ortotopica. Urologia 2010. [DOI: 10.1177/0391560310077016s07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Today, the most widely employed “solution” after radical cystectomy is bladder substitution through the creation of an othotopic neobladder. Many kind of othotopic neobladders have been proposed and employed and, during the last 20 years, we have observed a continuous improvement of such techniques. Nevertheless, notwithstanding these technical improvements, patients with orthotopic neobladder can still report many various complications. Thus, a specific “functional” follow-up is mandatory; “functional” follow-up should be associated and integrated to oncological follow-up that these patients usually undergo. Functional follow-up should be lifelong.
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Affiliation(s)
- P Destefanis
- Divisione Universitaria di Urologia 2 - Ospedale San Giovanni Battista “Molinette” - Torino
| | - D. Fontana
- Divisione Universitaria di Urologia 2 - Ospedale San Giovanni Battista “Molinette” - Torino
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Nieuwenhuijzen JA, de Vries RR, Bex A, van der Poel HG, Meinhardt W, Antonini N, Horenblas S. Urinary Diversions after Cystectomy: The Association of Clinical Factors, Complications and Functional Results of Four Different Diversions. Eur Urol 2008; 53:834-42; discussion 842-4. [PMID: 17904276 DOI: 10.1016/j.eururo.2007.09.008] [Citation(s) in RCA: 198] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2007] [Accepted: 09/10/2007] [Indexed: 11/21/2022]
Abstract
PURPOSE We present a single institute experience of the four most widely used diversions after cystectomy in 281 patients, with an evaluation of the association between clinical factors, complication rates, functional results, and metabolic complications. MATERIALS AND METHODS Between 1990 and 2005, 281 consecutive cystectomies were performed at our institute. Four different diversions were offered: an ileal conduit according to Bricker (IC; 118 patients), an Indiana pouch (IP; 51 patients), and orthotopic diversions after cystectomy/neobladder (N; 62 patients), or sexuality-preserving cystectomy and neobladder (SPCN; 50 patients). RESULTS Forty-four percent developed early complications: IC 48%, IP 43%, N 42%, and SPCN 38%. High ASA score was the only variable significantly associated with early major complications (ASA 1 vs. 3: HR, 0.32; 95%CI, 0.14-0.72). Late complication rate was 51% with fewer complications in the IC group, IC 39%, IP 63%, N 59%, and SPCN 60% (HR, 0.32; 95%CI, 0.14-0.72), which was explained by fewer uncomplicated urinary tract infections (one third of all late complications) in the IC group. There were no differences in experienced late major complications. We found no significant association between tumour stage, ASA, age, preoperative radiotherapy, gender, and diversion-related complication rates. Complete daytime and nighttime continence, respectively, was achieved in 96% and 73% after IP, 90% and 67% after neobladder, and 96% and 67% after SPCN. Metabolic changes were found in 24% of the patients: 21% after IC, 26% after IP, and 28% after orthotopic diversion (neobladder and SPCN combined); low vitamin B12 was measured in 23%, 15%, and 15% respectively. CONCLUSIONS Cystectomy with any subsequent diversion remains a procedure with considerable morbidity. High ASA score was associated with more early complications. Orthotopic diversions provide good functional results, but at the cost of more late complications compared with ileal conduits. We found no evidence that age, ASA score, positive lymph nodes, extravesical tumour growth, or previous radiotherapy were contraindications per se for any diversion.
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Affiliation(s)
- Jakko A Nieuwenhuijzen
- Department of Urology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
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Gerharz EW, Turner WH, Kälble T, Woodhouse CRJ. Metabolic and functional consequences of urinary reconstruction with bowel. BJU Int 2003; 91:143-9. [PMID: 12519116 DOI: 10.1046/j.1464-410x.2003.04000.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- E W Gerharz
- Department of Urology, Julius Maximilians University Medical School, Würzburg, Germany.
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Ganesan T, Khadra MH, Wallis J, Neal DE. Vitamin B12 malabsorption following bladder reconstruction or diversion with bowel segments. ANZ J Surg 2002; 72:479-82. [PMID: 12123505 DOI: 10.1046/j.1445-2197.2002.02460.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Vitamin B12 is absorbed exclusively in the terminal ileum the resection of which may produce malabsorption of B12. The present study aimed to determine whether the length or specific segment of the intestine used in bladder reconstruction affects the overall incidence of B12 malabsorption. It was also aimed at the reasonable way of following these patients. METHODS Seventy patients who underwent urinary reconstruction between 1988 and 1997 were studied: 28 had undergone orthotopic reconstruction, 14 had ileal conduit diversion, 8 had continent diversion and 20 had undergone enterocystoplasty. The median follow up was 65 months (10-137 months). Indications for operation included carcinoma of the bladder, neurogenic bladder dysfunction, idiopathic detrusor instability and interstitial cystitis. Schilling tests were performed, and serum B12 level and haematological indices were measured. RESULTS Patients were classified depending on whether the ileocaecal junction was used. Group 1 included ileal conduit and entero-cystoplasty where 15-20 cm of ileum, 15-20 cm from ileocaecal junction was used. Group 2 consisted of orthotopic reconstruction and continent diversions where the ileocaecal segment was used. Group 3 comprised patients in whom long ileal segments (50-60 cm) had been used for reconstruction. Five patients in group 1 and one in group 2 had low B12 levels, but none had developed neuropathy or megaloblastic anaemia. One patient in group 1, and six patients in group 2 had low Schilling tests indicating intestinal malabsorption of B12. No patient in group 3 had a low B12 or an abnormal Schilling test. CONCLUSION This study showed that use of ileocaecal segments results in intestinal malabsorption of B12. The length of ileum alone does not seem to be the determinant factor in causing B12 deficiency or B12 malabsorption.
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Affiliation(s)
- Thirumalai Ganesan
- Department of Urology, Manchester Royal Infirmary, Manchester, United Kingdom.
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Affiliation(s)
- Arthur I. Sagalowsky
- From the Departments of Urology and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Eugene P. Frenkel
- From the Departments of Urology and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
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Olofsson G, Kilander A, Lindgren A, Ung KA, Jonsson O. Vitamin B12 metabolism after urinary diversion with a Kock ileal reservoir. SCANDINAVIAN JOURNAL OF UROLOGY AND NEPHROLOGY 2001; 35:382-7. [PMID: 11771865 DOI: 10.1080/003655901753224440] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To elucidate the influence of construction of a Kock reservoir for urinary diversion using 70 cm of the distal ileum on vitamin B12 metabolism. MATERIAL AND METHODS Blood samples for determination of cobalamin concentrations were drawn up to 18 years after construction of a Kock reservoir in 97 patients. Preoperative values were obtained in 20 of these patients. Pre- and postoperative Schilling tests and analyses of methylmalonic acid and homocysteine concentrations were performed in subgroups. RESULTS The operation did not induce a significant decrease in cobalamin uptake as reflected in the pre- and postoperatively performed Schilling tests. No significant decline in cobalamin concentration postoperatively was noted. The value of analysis of methylmalonic acid and homocysteine concentrations in finding patients with cobalamin deficiency is limited by the fact that kidney function influences the results. Ten per cent of the patients did develop true cobalamin deficiency. A postoperative vitamin B12 value below 200 pmol/l indicates a 50% risk of later cobalamin deficiency. CONCLUSIONS The construction of a Kock reservoir does not per se cause cobalamin deficiency. Substitution should be instituted at a postoperative concentration below 200 pmol/l.
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Affiliation(s)
- G Olofsson
- Department of Urology, Sahlgrenska University Hospital, Göteborg, Sweden
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Uygur MC, Tan MO, Altug U, Yilmaz C, Erol D. Clinical, urodynamic and endoscopic characteristics of the stanford pouch ileal neobladder constructed with absorbable staples. Int J Urol 2000; 7:440-6. [PMID: 11168682 DOI: 10.1046/j.1442-2042.2000.00227.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE The clinical, urodynamic and endoscopic aspects of the Stanford pouch ileal neobladder formed with absorbable staples were investigated. METHODS A Stanford pouch ileal neobladder was formed using absorbable staples after radical cystoprostatectomy in 30 male patients with the diagnosis of muscle invasive carcinoma of the bladder between 1995 and 1998. The mean age of the patients was 62 (range 41-70) years. Patients were followed with arterial blood gas, serum biochemistry, pouch cystography, urodynamic tests and endoscopy. RESULTS Five (16.7%) patients had early postoperative complications and three were related to the neobladder. One year postoperatively, low grade (I, II) vesicoureteral reflux was present in five (16.7%) cases. The mean preoperative and 6 months postoperative serum creatinine levels were 1.07+/-0.3 mg/dL and 1.2+/-0.4 mg/dL, respectively, but the difference was not statistically significant (P=0.1). Six months postoperatively the mean serum chloride level was 109+/-4.5 (range 100-113) mmol/L and the mean arterial blood pH was 7.37+/-0.2 (range 7.3-7.4). Two (6.7%) patients required oral alkaline supplementation because of high chloride levels. All the patients except one were continent throughout the day after 1 year. However, nocturnal enuresis was present in 25 (83.3%) cases. The pouch capacity was increased gradually up to 12 months postoperatively and the mean pouch capacity 12 months postoperatively was 460+/-95.8mL. Micturition occurred spontaneously in most patients while some needed abdominal straining. None of the patients had a residual urine of more than 60 mL. The mean maximum flow rate 6 months postoperatively was 9.8 (range 5.4-15.0) mL/s. After 6 months the stapled edge was noticed as a nodular line. One year postoperatively only a white scar could be observed at the suture line. CONCLUSION The Stanford pouch ileal neobladder constructed using absorbable staples was able to provide a good capacity low pressure reservoir with a low rate of complications.
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Affiliation(s)
- M C Uygur
- Urology Clinic of Ministry of Health, Ankara Hospital, Turkey.
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Fujisawa M, Gotoh A, Nakamura I, Hara IS, Okada H, Yamanaka N, Arakawa S, Kamidono S. Long-term assessment of serum vitamin B(12) concentrations in patients with various types of orthotopic intestinal neobladder. Urology 2000; 56:236-40. [PMID: 10925085 DOI: 10.1016/s0090-4295(00)00638-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Vitamin B(12) deficiency is an important long-term problem after urinary diversion using an intestinal segment. In this study, we examined serum vitamin B(12) concentrations in patients with neobladders constructed from various intestinal segments to determine the anatomic factors important for avoiding vitamin B(12) deficiency. METHODS Twenty-two patients (19 men and 3 women) had an ileal neobladder (modified Studer type); 9 men had an ascending colonic neobladder (Goldwasser type); 30 patients (24 men and 6 women) had a sigmoid neobladder (modified Reddy type); and 18 (15 men and 3 women) had an ileocolic neobladder (Mainz type). The postoperative follow-up ranged from 3 months to 11 years (mean +/- SD, 3.4 +/- 2.8 years). The serum vitamin B(12) concentration was determined at several points after surgery. RESULTS No patient with a neobladder fashioned from ascending or sigmoid colon developed a low vitamin B(12) concentration. Of the 18 patients with an ileocolic neobladder, 3 (16.6%) developed decreased serum vitamin B(12) concentrations after 5 to 6 years. Of the 22 patients with an ileal neobladder, 3 (13.6%) developed a low serum concentration of vitamin B(12) between 9 months and 3 years after surgery. No patient developed megaloblastic anemia or neurologic symptoms. CONCLUSIONS Preservation of the terminal 15 cm of ileum is not sufficient to ensure adequate vitamin B(12) absorption, and thus, preserving the ileal length is important. Use of colonic segments to construct neobladders appears to be preferable to ileal segments to preserve vitamin B(12) absorption.
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Affiliation(s)
- M Fujisawa
- Department of Urology, Kobe University School of Medicine, Kobe, Japan
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Capristo E, Addolorato G, Mingrone G, De Gaetano A, Greco AV, Tataranni PA, Gasbarrini G. Changes in body composition, substrate oxidation, and resting metabolic rate in adult celiac disease patients after a 1-y gluten-free diet treatment. Am J Clin Nutr 2000; 72:76-81. [PMID: 10871564 DOI: 10.1093/ajcn/72.1.76] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The incidence of celiac disease has been on the rise in both Europe and the United States. Celiac disease patients are at high risk of undernutrition because of nutrient malabsorption. OBJECTIVE The aim of the present study was to evaluate changes in body composition and energy metabolism in a group of patients with celiac disease before and after consumption of a gluten-free diet (GFD). DESIGN Body composition (by anthropometry and isotopic dilution), resting metabolic rate (RMR), and substrate oxidation rates (by indirect calorimetry) were assessed in 39 adult celiac disease patients (16 men and 23 women) with a mean (+/-SD) age of 29. 9 +/- 7.6 y, weight of 58.3 +/- 6.6 kg, and percentage body fat of 20.1 +/- 6.7%, and in 63 (29 men and 34 women) age- and height-matched control subjects (age: 33.2 +/- 8.1 y; weight: 66.8 +/- 6.6 kg; and percentage body fat: 25.4 +/- 3.7%). Celiac disease patients were studied twice, at diagnosis and 1 y after treatment with a GFD. RESULTS Before treatment, celiac disease patients had a lower body weight (P < 0.05) and a higher carbohydrate oxidation rate (P < 0.01) than did control subjects. Carbohydrate oxidation rates correlated positively with fecal lipid loss in untreated celiac disease patients (r = 0.80, P < 0.0001). After the GFD, percentage body fat was higher in celiac disease patients than in control subjects (P < 0.01), and lipid intakes tended to be higher than before treatment. CONCLUSIONS This longitudinal study showed that the GFD treatment significantly increased body fat stores. Untreated patients preferentially utilized carbohydrates as a fuel substrate, probably as a consequence of both lipid malabsorption and a high carbohydrate intake, and lipid utilization increased with the restoration of the intestinal mucosa.
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Affiliation(s)
- E Capristo
- Department of Internal Medicine, CNR-Centro Fisiopatologia dello Shock, Università Cattolica del Sacro Cuore, Rome, Italy.
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Woodhouse CR. What is new in urinary diversion. Curr Opin Urol 1999; 9:247-51. [PMID: 10726099 DOI: 10.1097/00042307-199905000-00010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
There have been some suggestions for changes in technique and investigations of the quality of life. As experience has grown, there have been increasing numbers of reports of complications. Careful attention to technique, especially in nerve-sparing cystectomy and orthotopic cystoplasty may reduce the rate of incontinence. Increasing awareness of quality of life issues should improve preoperative counselling of patients, especially those whose underlying condition is not life-threatening.
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Affiliation(s)
- C R Woodhouse
- Institute of Urology and Nephrology, Royal Marsden Hospital, London, UK
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Abstract
Preliminary data have shown that composite reservoirs consisting of gastric segments in combination with ileum or colon may reduce metabolic problems. Orthotopic neobladders are the most natural way to reconstruct the urinary bladder and are a safe option in selected male and female patients. Experimental and preliminary clinical data about new methods using autologous muscle transfer and tissue engineering are promising.
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Affiliation(s)
- A Stenzl
- Department of Urology, University of Innsbruck Medical School, Austria.
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Eisenberger CF, Schoenberg M, Fitter D, Marshall FF. Orthotopic ileocolic neobladder reconstruction following radical cystectomy: history, technique and results of the Johns Hopkins experience, 1986-1998. Urol Clin North Am 1999; 26:149-56, ix. [PMID: 10086056 DOI: 10.1016/s0094-0143(99)80012-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Reconstruction of the lower urinary tract using intestinal segments has become a standard component of the treatment of patients with bladder cancer. A variety of intestinal segments can be successfully used for this purpose. Between 1986 and 1998, the authors have used a composite ileocolic segment for neobladder reconstruction in patients desiring orthotopic reconstruction of the lower urinary tract. The early and late complication rates are 11% and 30%, respectively. Forty-five percent of men are potent postoperatively. Seventy-six percent of patients are continent both day and night. Three percent of our patients experience nocturnal enuresis, and 15% perform clean intermittent catheterization. Bothersome daytime stress urinary incontinence occurs in 3% of patients evaluated for this report. Although no contemporary studies demonstrate the superiority of a particular bowel segment for lower urinary tract reconstruction, the authors' long-term experience with the ileocolic neobladder suggests that this composite segment provides excellent results for lower urinary tract reconstruction after radical cystectomy.
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Affiliation(s)
- C F Eisenberger
- James Buchanan Brady Urological Institute, Johns Hopkins University Medical Institutions, Baltimore, Maryland, USA
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RACIOPPI MARCO, MINGRONE GELTRUDE, D'ADDESSI ALESSANDRO, FANASCA ANGELO, BENEDETTI GIUSEPPE, CAPRISTO ESMERALDA, ALCINI ANTONIO, ALCINI EUGENIO. XYLOSE ABSORPTION AND METABOLIC STATUS IN URINARY INTESTINAL ORTHOTOPIC RESERVOIR: ILEOCECAL COMPARED WITH ILEAL NEOBLADDER. J Urol 1998. [DOI: 10.1016/s0022-5347(01)62374-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- MARCO RACIOPPI
- From the Department of Urology, Institute of Internal Medicine, Universita Cattolica del Sacro Cuore Rome, Italy
| | - GELTRUDE MINGRONE
- From the Department of Urology, Institute of Internal Medicine, Universita Cattolica del Sacro Cuore Rome, Italy
| | - ALESSANDRO D'ADDESSI
- From the Department of Urology, Institute of Internal Medicine, Universita Cattolica del Sacro Cuore Rome, Italy
| | - ANGELO FANASCA
- From the Department of Urology, Institute of Internal Medicine, Universita Cattolica del Sacro Cuore Rome, Italy
| | - GIUSEPPE BENEDETTI
- From the Department of Urology, Institute of Internal Medicine, Universita Cattolica del Sacro Cuore Rome, Italy
| | - ESMERALDA CAPRISTO
- From the Department of Urology, Institute of Internal Medicine, Universita Cattolica del Sacro Cuore Rome, Italy
| | - ANTONIO ALCINI
- From the Department of Urology, Institute of Internal Medicine, Universita Cattolica del Sacro Cuore Rome, Italy
| | - EUGENIO ALCINI
- From the Department of Urology, Institute of Internal Medicine, Universita Cattolica del Sacro Cuore Rome, Italy
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RACIOPPI MARCO, MINGRONE GELTRUDE, D'ADDESSI ALESSANDRO, FANASCA ANGELO, BENEDETTI GIUSEPPE, CAPRISTO ESMERALDA, ALCINI ANTONIO, ALCINI EUGENIO. XYLOSE ABSORPTION AND METABOLIC STATUS IN URINARY INTESTINAL ORTHOTOPIC RESERVOIR. J Urol 1998. [DOI: 10.1097/00005392-199811000-00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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