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A study of reflux in patients with an ileal orthotopic bladder
R Waidelich1, F Rink, M Kriegmair
1Department of Urology, University of Munich, Germany.
Objective:
To determine whether there is vesico-ureteric reflux during voiding in patients who had undergone an ileal bladder substitution after cystectomy.
Patients And Methods:
The study comprised 15 patients (13 men and two women) who had undergone radical cystectomy and construction of a Studer ileal neobladder. At 1-24 months (median 4) after the operation indirect radionuclide cystography (IRC) was performed after isotopic renography (using 99m-technetium mercapto-acetyltriglycine) and voiding cysto-urethrography (VCUG).
Results:
None of the patients had reflux during voiding, either on IRC or on VCUG. Renal function and morphology remained stable in all patients. Despite bacteriuria occurring in four patients, no episode of pyelonephritis was reported.
Conclusion:
There was no vesico-ureteric reflux during voiding in patients with a Studer ileal bladder substitution. However, long-term follow-up is needed to finally determine whether an antirefluxive ureteric implantation is required to protect the upper urinary tract in patients with ileal low-pressure bladder substitutions.