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Related Experiment Videos

Voiding dysfunction in the orthotopic neobladder.

W D Steers1

  • 1University of Virginia Health System, Department of Urology, Charlottesville 22908, USA. wds6t@Virginia.edu

World Journal of Urology
|December 29, 2000
PubMed
Summary
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Neobladder surgery can lead to voiding dysfunction, including retention and incontinence. Fluoro-urodynamic evaluation helps diagnose persistent issues, guiding therapy for improved quality of life after bladder removal.

Area of Science:

  • Urology
  • Surgical Oncology
  • Reconstructive Surgery

Background:

  • Orthotopic neobladder reconstruction is a common procedure after radical cystectomy.
  • Voiding dysfunction can significantly impair quality of life following neobladder creation.
  • Persistent voiding issues necessitate thorough evaluation and targeted therapeutic strategies.

Purpose of the Study:

  • To review the causes and management of voiding dysfunction after orthotopic neobladder construction.
  • To highlight the factors influencing neobladder outcomes and the risk of complications.
  • To emphasize the importance of prevention through surgical technique and patient selection.

Main Methods:

  • Review of literature on neobladder construction and associated voiding dysfunction.

Related Experiment Videos

  • Analysis of factors affecting neobladder function, including type of bowel segment, configuration, and surgical technique.
  • Discussion of diagnostic methods like fluoro-urodynamics and therapeutic options for retention and incontinence.

    • Main Results:

    • Voiding dysfunction, including urinary retention and incontinence, is a significant complication of neobladder surgery.
    • Neobladder type (ileal favored), configuration (S or W), length, surgical technique, patient age, and sex influence voiding outcomes.
    • Urinary retention is more prevalent in women, often linked to urethral obstruction.
    • Stress incontinence relates to reduced outlet resistance, while nocturnal incontinence stems from diminished sensation and storage reflexes.

    Conclusions:

    • Voiding dysfunction after neobladder surgery requires fluoro-urodynamic assessment if persistent beyond 6-12 months.
    • Management strategies vary from self-catheterization for retention to bulking agents or artificial sphincters for incontinence.
    • Prevention is key, emphasizing careful neobladder design, surgical precision, and appropriate patient selection to minimize voiding complications.