[Orthotopic urinary bladder replacement in the woman. Initial clinical experiences]

Area of Science:

• Urology
• Surgical Oncology
• Reconstructive Surgery

Background:

• Ileum neobladder urinary diversion after cystectomy is typically reserved for male patients.
• Female patients are often excluded due to concerns about post-operative incontinence.
• The efficacy of orthotopic bladder substitution in females remains an area of investigation.

Observation:

• This study reports on seven female patients who underwent successful orthotopic bladder reconstruction.
• The procedure utilized an ileum neobladder technique (Hautmann) combined with colposuspension plasty (Marshall-Marchetti).
• Patient cases included post-radiation bladder dysfunction and bladder carcinoma requiring radical cystectomy.

Findings:

• The ileum neobladder was successfully anastomosed with the preserved urethral stump in all seven patients.
• The addition of colposuspension plasty was instrumental in achieving urinary continence.
• Follow-up extended up to 4.5 years, demonstrating sustained functional outcomes.

Implications:

• These findings suggest that ileum neobladder reconstruction is a feasible and effective option for female patients.
• The modified technique offers a promising solution for urinary diversion and continence preservation in women.
• This approach expands the possibilities for bladder reconstruction in the female population.