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[Urodynamic evaluation of replacement bladders (Mainz)]

C Simeone1, G Pezzotti, D Zani

  • 1Divisione Clinicizzata di Urologia, Università di Brescia.

Archivio Italiano Di Urologia, Andrologia : Organo Ufficiale [Di] Societa Italiana Di Ecografia Urologica E Nefrologica
|December 1, 1996
PubMed
Summary

Orthotopic ileo-colonic reservoirs (M.A.I.N.Z.) demonstrate large capacity and low pressure post-cystectomy. Nocturnal incontinence may correlate with increased urine osmolality, suggesting potential management strategies.

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Area of Science:

  • Urology
  • Surgical Oncology
  • Nephrology

Background:

  • Radical cystectomy for bladder cancer often necessitates urinary diversion.
  • Ileo-colonic orthotopic reservoirs (M.A.I.N.Z.) are a common type of urinary diversion.
  • Long-term functional outcomes and potential complications require thorough evaluation.

Purpose of the Study:

  • To evaluate the urodynamic characteristics of M.A.I.N.Z. reservoirs.
  • To compare long-term versus short-term follow-up results.
  • To investigate factors contributing to nocturnal incontinence.

Main Methods:

  • Urodynamic studies were performed on 42 patients with M.A.I.N.Z. reservoirs.
  • Patients were divided into two groups: long-term (>36 months) and short-term follow-up.

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  • Hyperosmotic solutions were instilled during cystometry to assess reservoir response.

    • Main Results:

    • Urodynamic evaluation revealed reservoirs with large capacity and low intracavitary pressure in both follow-up groups.
    • Nocturnal incontinence was observed occasionally in some patients.
    • Instillation of hyperosmotic solution increased intracavitary pressure wave amplitude and frequency.

    Conclusions:

    • M.A.I.N.Z. reservoirs maintain favorable urodynamic properties long-term.
    • Nocturnal incontinence is a potential issue, possibly linked to nocturnal urine osmolality.
    • Further research is warranted to elucidate the mechanisms and management of incontinence.