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Long-term experience with orthotopic reconstruction of the lower urinary tract in women
H Shimogaki1, H Okada, M Fujisawa
1Department of Urology, Shinko Hospital and Kobe University School of Medicine, Japan.
Purpose:
We investigated the long-term outcome of orthotopic neobladders in women.
Materials And Methods:
At our institutions 8 women have undergone lower urinary tract reconstruction with an orthotopic neobladder and have been followed for more than 4 years. After urethral sparing cystectomy the neobladder was constructed and connected to the native urethra. Late complications were analyzed, and voiding function was evaluated by a pressure flow micturition study and bead-chain cystourethrography.
Results:
No late complications related to the surgery were noted. Of the 8 patients 7 were completely dry day and night. Four patients with ileal neobladder required clean intermittent catheterization, and hypercontinence might have been caused by downward migration of the neobladder and reduced neobladder pressure at voiding. No recurrence in the native urethra was noted, and all patients were satisfied postoperatively.
Conclusions:
These results of orthotopic neobladder in women are encouraging. Overall patient satisfaction was excellent. An international collaborative study is necessary to achieve the number of patients required to determine the ideal orthotopic neobladder for women.