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Right colocystoplasty for bladder replacement.

L Zinman, J A Libertino

The Urologic Clinics of North America

|May 1, 1986

Summary

This study explores ileoascending colon bladder replacement for male patients with bladder cancer or interstitial cystitis. The technique provides a functional reservoir, antireflux barrier, and tension-free anastomosis, with rare early catheter obstruction.

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Area of Science:

Urology
Surgical Oncology
Reconstructive Surgery

Background:

Invasive bladder cancer and interstitial cystitis necessitate bladder removal.
Urinary diversion options require careful consideration for reservoir capacity, antireflux mechanisms, and anastomosis.
Previous methods may present challenges with mucous plug formation.

Purpose of the Study:

To evaluate the efficacy of total bladder replacement using an ileoascending colonic segment.
To assess the functional outcomes, including reservoir capacity and anastomosis, in male patients.
To determine the incidence of early postoperative complications, specifically mucous plug obstruction.

Main Methods:

Selective use of ileoascending colonic segment for total bladder replacement in male patients.
Adjunctive intermittent self-catheterization and secondary artificial sphincter insertion.
Surgical technique focused on achieving a capacious reservoir and tension-free anastomosis.

Main Results:

The ileoascending colonic segment provided a capacious reservoir and an effective antireflux barrier.
A consistent tension-free colourethral or coloprostatic anastomosis was achieved.
Mucous plug catheter obstruction was rarely encountered in the early postoperative period.

Conclusions:

Ileoascending colonic bladder replacement is a viable option for select male patients requiring cystectomy.
This technique offers significant functional advantages for urinary reconstruction.
The method demonstrates a favorable early safety profile regarding catheter obstruction.

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