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Bladder Replacement and Urinary Diversion After Radical Cystectomy.

Pow-Sang1, Spyropoulos, Helal

  • 1Genitourinary Oncology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida 33612, USA.

Cancer Control : Journal of the Moffitt Cancer Center
|November 1, 1996
PubMed
Summary

Urinary tract reconstruction after cystectomy has advanced, offering improved techniques for continent urinary diversion and bladder replacement. While complications exist, most patients experience minimal morbidity and mortality with modern surgical approaches.

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Area of Science:

  • Urology
  • Surgical Oncology
  • Reconstructive Surgery

Background:

  • Urinary tract reconstruction after cystectomy presents ongoing challenges for urologic surgeons.
  • Existing bowel conduit methods have limitations, driving the need for improved techniques.
  • Patient outcomes are paramount in selecting optimal reconstruction methods.

Purpose of the Study:

  • To review the evolution of urinary tract reconstruction techniques post-cystectomy.
  • To present results from various continent urinary diversion and bladder replacement procedures.
  • To share institutional experience with continent reservoirs and neobladders in over 400 patients.

Main Methods:

  • Literature review of urinary tract reconstruction development.
  • Presentation of surgical outcomes for continent urinary diversion and neobladder construction.

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  • Analysis of a cohort of over 400 patients undergoing these procedures.

    • Main Results:

    • Multiple surgical options for continent urinary diversion are now available.
    • Potential complications include metabolic/nutritional issues, stones, infection, and cancer.
    • The study reports on the authors' extensive experience with continent reservoirs and neobladders.

    Conclusions:

    • Surgical advancements and improved understanding of bowel segment physiology have transformed urinary reconstruction.
    • Enhanced pre- and post-operative care contribute to better patient outcomes.
    • Modern urinary reconstruction after cystectomy generally results in minimal patient morbidity and mortality.