Clinical Experience With the N-Shaped Ileal Neobladder: Assessment of Complications, Voiding Patterns, and Quality of Life in our Series of 58 Patients

Joniau, Steven; Benijts, J.; Kampen, Marijke Van; Waele, Marc De; Ooms, Joris F.; Cleynenbreugel, Ben Van; Poppel, H. Van

doi:10.1016/s0022-5347(06)00203-5

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“…Between January 1987 and December 2002, 189 patients with bladder cancer had a RC and orthotopic neobladder at our institution. We retrospectively reviewed the records of 111 eligible patients who lived for >5 years after surgery, an ileal neobladder (Studer type [12], modified Studer type [13], or Hautmann type [14]) was constructed in 62 patients (58 men and four women); an ascending colonic neobladder (Goldwasser type [15]) in 14 (12 men and two women); a sigmoid colonic neobladder (modified Reddy type [16]) in 21 (15 men and six women); and an ileocolonic neobladder (Mainz type [17]) in 14 (13 men and one woman). In all, 42 patients died with bladder cancer, 14 with other diseases, and 22 were lost to follow‐up at the assessment.…”

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confidence: 99%

Assessment of voiding function of orthotopic neobladders in elderly patients with long‐term survival

et al. 2009

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OBJECTIVE To compare the voiding status in elderly patients (aged ≥80 years) with that in younger patients undergoing orthotopic neobladder substitution during long‐term survival. PATIENTS AND METHODS The voiding status was assessed in 111 patients (ileal neobladder in 62, ascending colonic neobladder in 14, sigmoid colonic neobladder in 21 and ileocolonic neobladder in 14) who lived for >5 years after radical cystectomy with an orthotopic neobladder, using a self‐completed questionnaire and uroflowmetry. According to the age at the time of these assessments, patients were divided into two groups (group 1, <80 years, 94; group 2, ≥80 years, 17). The voiding status was compared between the groups. RESULTS In all, 78 patients (92%) in group 1 and 16 (94%) in group 2 were capable of spontaneous voiding. In group 1 and 2, respectively, daytime continence was achieved by 67 (74%) and 12 (75%) patients, but night‐time continence was achieved by 54 (60%) and six (38%), although the difference was not statistically significant. In groups 1 and 2, respectively, the median maximum flow rate was 13.3 and 11.7 mL/s and the median postvoid residual urine volume was 19 and 18 mL. The only statistically significant difference was for voiding posture, assessed in men. CONCLUSIONS There was no significant difference in voiding status of patients with orthotopic neobladders except for voiding posture between patients aged <80 or carefully selected elderly patients aged ≥80 years during long‐term survival. However, night‐time continence might be clinically worse in the elderly than in the younger group.

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