[Four cases of bladder replacement by enterocystoplasty after radical cystectomy for bladder cancer]

Four male patients with invasive bladder cancer, 44 to 68 years old in age, underwent bladder replacement with ileum after radical cystectomy. In three patients an ileal segment alone was isolated for construction of neobladder, and in the fourth patient, the terminal portion of the ileum, the cecum and the proximal part of the ascending colon were isolated for the bladder replacement. In all the cases isolated segments were detubularized for obtaining a low pressure reservoir. All the patients, except one who had a past history of cerebro-vascular disease and was performing intermittent self-catheterization because of a kind of detrusor-sphincter dyssynergia of the ileal-neobladder, are now enjoying almost the same voluntary urination as before the operation. Serum creatinine, BUN and electrolytes are all normal during the postoperative observation period, although a very slight metabolic acidosis was observed in 3 patients. Ten to 16 months have passed without any complications and all the patients are alive without any sign of tumor recurrence or metastatic involvement.