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Related Experiment Videos

Voiding dysfunction in ileal neobladder

N Mikuma1, T Hirose, A Yokoo

  • 1Department of Urology, Sapporo Medical University School of Medicine, Japan.

The Journal of Urology
|September 25, 1997
PubMed
Summary

Ileal neobladder patients void using abdominal straining and pelvic floor relaxation. Optimal voiding requires proper neobladder opening placement and outlet elasticity to prevent dysfunction.

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Area of Science:

  • Urology
  • Surgical Oncology
  • Reconstructive Surgery

Background:

  • Ileal neobladders are urinary diversions created after radical cystectomy for bladder cancer.
  • Voiding dysfunction can occur in patients with ileal neobladders, impacting quality of life.

Purpose of the Study:

  • To elucidate the voiding mechanism in ileal neobladder patients.
  • To identify the causes of voiding dysfunction in this patient population.

Main Methods:

  • Pressure-flow studies and voiding cystourethrography were performed on 12 bladder cancer patients with ileal neobladders.
  • Patients were categorized into 'fine voiders' (max flow rate ≥ 15 ml/s) and 'poor voiders' (max flow rate < 15 ml/s).

Main Results:

  • Poor voiders exhibited significantly lower maximum flow rates and required more straining to void compared to fine voiders.
  • Voiding cystourethrography showed a lack of neobladder outlet funneling during straining in poor voiders, unlike fine voiders.
  • Key parameters like bladder capacity and vesical pressures were similar between groups, suggesting outlet dynamics are critical.

Conclusions:

  • Ileal neobladder voiding relies on abdominal straining and pelvic floor relaxation.
  • Successful voiding is facilitated by a caudally positioned neobladder opening and preserved outlet elasticity.
  • These factors are crucial for preventing voiding dysfunction in ileal neobladder reconstruction.

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