Continent urinary diversion after radical cystectomy: 3 years' experience

The authors performed 27 continent urinary diversions among 36 urinary diversion operations between 1992 and 1995. Fifteen orthotopic diversions (14 ileal neobladders, 1 sigma neobladder) and 12 Mainz pouch II were created. During these 3 years, 4 patients died after operation. Tumour progression was observed in four patients. Three ureteral and 1 urethral stricture developed, 1 patient had complete incontinence (after Mainz pouch II operation) and another three had stress and night incontinence. In 12 patients a modified Hautmann operation was performed (modified by the authors) and the ureters were implanted in a 15 cm long tubular afferent ileum. Also they changed the conventional Goodwin technique for ureter implantation in Mainz pouch II operation and instead they used the Paquin technique for ureter reimplantation in the sigma. The authors concluded according to the literature and their own results that continent urinary diversion (ileal or sigma neobladder or Mainz pouch II) could be the first choice after radical cystectomy to achieve for these patients a better quality of life.