No abstract

Laparoscopic removal of urinary bladder leiomyomas is a suitable alternative to common therapeutical procedures.

Background: Vescica ileala padovana (VIP) is a technique of bladder substitution following radical cystectomy with the advantage of resulting in a shape that anatomically resembles the real bladder. We studied whether the VIP neobladder is a viable alternative following cystectomy. Patients and Methods: Forty-five patients with muscle invasive bladder cancer were treated with radical cystectomy and VIP neobladder formation. Both perioperative and postoperative complications together with short- and long-term results were discussed. Results: In the early postoperative period there was one patient (2.2%) who developed ileus and one death (2.2%) due to a massive pulmonary embolism. During follow-up, 2 patients (4.4%) presented with hernias and 1 died from metastatic disease (2.2%), 3 patients (6.6%) developed ureteroileal strictures and 1 developed (2.2%) urethroileal stenosis. During follow-up, maximum capacity increased (540 ± 89 vs. 590 ± 54 ml, p = 0.014) while Qmax and end-filling pressure decreased (18 ± 2 vs. 14 ± 4 ml/s, p = 0.002 and 22 ± 3 vs. 15 ± 6 cm H2O, p = 0.012). The number of intrinsic contractions remained stable (4 ± 1 vs. 5 ± 1, p = 0.066). Daytime continence between the 3rd and the 36th month was stable (40 vs. 39 pts, 88.8 vs. 86.6%, p = 0.09). Twenty-six patients were continent during the night and this number increased to 30 patients (57.8 vs. 66.7%, p = 0.013). Conclusions: VIP has a favorable outcome and can be used for bladder orthotopic substitution following cystectomy.