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Long-term functional outcome and late complications of Studer's ileal neobladder
Toshiaki Tanaka1, Hiroshi Kitamura, Atsushi Takahashi
1Department of Urology, School of Medicine, Sapporo Medical University, N-1, W-16, Chuo-ku, Sapporo, Hokkaido 060-8543, Japan. zappa@pop12.odn.ne.jp
Objective:
The purpose of this study was to evaluate the long-term functional outcome and late complications of Studer's ileal neobladder.
Methods:
The study included 57 patients who underwent radical cystectomy and bladder reconstruction with Studer's ileal neobladder, and were followed-up for at least 3 months after surgery. The voiding and storage function, and late complications were evaluated. The times of evaluation after surgery were categorized into periods I (3-23 months), II (24-59 months), III (60-95 months) and IV (> or =96 months).
Results:
Daytime and night-time continence rates were 95.6 and 88.6%, respectively. The averages of functional capacity (439 ml), maximum flow rate (15.7 ml/s) and residual urine (35 ml) evaluated in period I were maintained in period IV. Of the 57 patients, intermittent self-catheterization was needed in five (8.8%) due to incomplete emptying or urinary retention. Urethroileal anastomotic stricture was found in two patients (3.5%), who were successfully treated by transurethral intervention. Inguinal hernia was found in seven patients (12.8%), five of whom developed it within 2 years after surgery.
Conclusions:
Our results indicate that Studer's ileal neobladder had a favorable long-term functional outcome. Although late complication rates were low, the incidence of inguinal hernia was relatively high, and this was considered as a definite late complication in our study.
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