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Orthotopic bladder substitution in women: functional evaluation
B Ali-el-Dein1, E el-Sobky, M Hohenfellner
1Urology and Nephrology Center, Mansoura University, Egypt.
The Journal of Urology
|May 20, 1999
Summary
Orthotopic bladder substitution in women offers good functional outcomes after cystectomy, with most patients achieving daytime and nighttime continence. Anatomical factors, not functional issues, may hinder complete bladder emptying.
Area of Science:
- Urology
- Surgical Oncology
Background:
- Orthotopic bladder substitution is a novel procedure for women undergoing cystectomy.
- Assessing oncological and functional outcomes is crucial for this procedure.
Purpose of the Study:
- To evaluate the functional outcomes of orthotopic bladder substitution in women following radical cystectomy.
- Oncological outcomes were not assessed due to a short follow-up period.
Main Methods:
- Sixty women underwent radical cystectomy and orthotopic diversion (ileal W-neobladder or hemi-Kock reservoir).
- The study included patients with organ-confined invasive bladder cancer.
Main Results:
- No perioperative mortality occurred; complications included pulmonary embolism, deep vein thrombosis, ileus, and vaginal pouch fistula.
- 32 out of 43 followed patients achieved complete daytime and nighttime continence.
- Six women experienced difficulty emptying the neobladder due to acute angulation.
Conclusions:
- Orthotopic bladder substitution can yield satisfactory functional results in select women post-cystectomy.
- Difficulties with neobladder emptying appear to stem from anatomical issues.