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Bladder replacement with sigmoid colon after radical cystoprostatectomy.

P K Reddy, P H Lange

    Urology
    |April 1, 1987
    PubMed
    Summary
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    Sigmoid colon segments effectively replaced bladders in 10 patients after radical cystoprostatectomy. This technique resulted in good continence and voluntary emptying, offering an acceptable alternative for bladder reconstruction.

    Area of Science:

    • Urology
    • Surgical Oncology
    • Gastroenterology

    Background:

    • Radical cystoprostatectomy necessitates bladder reconstruction.
    • Various bowel segments are used for urinary diversion.
    • Assessing novel techniques for bladder replacement is crucial.

    Purpose of the Study:

    • To evaluate the efficacy and safety of using sigmoid colon for bladder replacement after radical cystoprostatectomy.
    • To assess functional outcomes, including continence and voiding, in patients undergoing this procedure.

    Main Methods:

    • Ten patients with bladder cancer underwent radical cystoprostatectomy with sigmoid colon bladder replacement.
    • A U- or J-shaped sigmoid segment was anastomosed to the urethral stump.
    • Ureters were implanted using an antireflux tunneling technique.

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    Main Results:

    • No operative mortality was observed.
    • Complications were minimal.
    • Eight out of ten patients achieved full daytime continence and voluntary emptying.
    • All patients experienced nocturnal enuresis managed with condom catheters.

    Conclusions:

    • Tubular sigmoid segment is a viable option for total bladder replacement.
    • This technique offers an acceptable alternative to ileum or cecum for bladder reconstruction.
    • Further research may explore long-term outcomes and patient quality of life.