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Bladder substitution.

Jürgen E Gschwend1

  • 1Department of Urology, University of Ulm, Prittwitz-Strasse 43, 89075 Ulm, Germany. juergen.gschwend@medizin.uni-ulm.de

Current Opinion in Urology
|October 16, 2003
PubMed
Summary

Orthotopic neobladders are a preferred urinary diversion after radical cystectomy for invasive bladder cancer. This review highlights their feasibility, safety, and excellent long-term functional outcomes in most patients.

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Area of Science:

  • Urology
  • Oncology
  • Surgical Innovation

Background:

  • Radical cystectomy with urinary diversion is standard for invasive bladder cancer.
  • Orthotopic neobladders are increasingly preferred for bladder substitution in eligible patients.
  • Recent advancements focus on optimizing outcomes and patient selection.

Purpose of the Study:

  • To review recent studies and reports on radical cystectomy and urinary diversion.
  • To evaluate orthotopic neobladders as a preferred method of bladder substitution.
  • To assess the feasibility and outcomes of orthotopic bladder substitution.

Main Methods:

  • Systematic review of last year's studies and reports.
  • Analysis of patient candidacy for radical cystectomy and orthotopic bladder substitution.
  • Comparison of complication rates and functional outcomes.

Main Results:

  • Orthotopic bladder substitution is feasible and well-tolerated, even in selected advanced cases.
  • Complication rates are comparable or lower than other diversion methods.
  • Long-term upper urinary tract protection is achieved with specific techniques.
  • Impact on quality of life remains an area for further investigation.

Conclusions:

  • Orthotopic neobladders offer excellent functional outcomes and voiding patterns.
  • This technique is favored for lower urinary tract reconstruction post-cystectomy.
  • Further research is needed on the impact of urinary diversion on patient well-being.

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