[Experience of ileal neobladder for bladder cancer by Hautmann procedure]

Operative results of ileal neobladder by the Hautmann procedure were studied in the patients with bladder cancer. From 1990 to 1993, 23 patients underwent total cystoprostatectomy for transitional cell carcinomas of the bladder. In 12 of these patients, an ileal neobladder was constructed for total bladder replacement under the following criteria; patients 1) with cancer confined in the bladder (T3b, M0, N0 or less), 20 without carcinoma in situ extending to more than half of urothelium of the bladder, 3) without cancerous lesion in the bladder neck or the prostatic urethra, 4) with performance status of 0 and the age of 75 or less. Pathologically, the disease was grade 2 in 3 patients, grade 3 in 9, stage pT1b in 3, stage pT2 in 4, stage pT3a in 1 and stage pT3b in 4. Two of 3 patients with the disease of stage pT1b had multiple papillary tumors. The remaining one patient had microinvasive cancer that carcinoma in situ infiltrated into submucosal area. Radical cystoprostatectomy and total bladder replacement by Hautmann procedure was performed in all patients. The maximum neobladder capacity was 349.5 +/- 58.1 ml (mean +/- SD). The intravesical pressure at maximum capacity was 30.6 +/- 6.2 cmH2O. At half maximum capacity, the intravesical pressure was 17.1 +/- 6.8 cmH2O. the maximum urethral closure pressure and the functional urethral length were 89.2 +/- 38.1 cmH2O and 25.5 +/- 7.0 mm, respectively. One patient had stress urinary incontinence. Slight nocturnal incontinence was found in 2 patients and nocturia was 1.86 +/- 0.55 times.(ABSTRACT TRUNCATED AT 250 WORDS)