Ileal Orthotopic Bladder Substitute Combined with an Afferent Tubular Segment: Long-Term Upper Urinary Tract Changes and Voiding Pattern

Perimenis, Petros; Burkhard, Fiona C.; Kessler, Thomas M.; Gramann, Tobias; Studer, Urs E.

doi:10.1016/j.eururo.2004.07.009

Cited by 43 publications

(24 citation statements)

References 27 publications

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“…Perimenis et al showed that older age was significantly associated with both higher daytime and nighttime incontinence rate as well as lower reservoir capacity [15,43]. This phenomena was also validated by Sogni et al who reported a daytime (56 %) and nighttime (25 %) continence rate in 85 patients with a mean age of 78 [40].…”

Section: Voiding Function-continence and Urinary Retentionmentioning

confidence: 63%

Urinary Diversion in the Elderly

Ayoub

Westney

2015

Curr Bladder Dysfunct Rep

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The elderly or older population segment has a heterogenous definition in the literature with the majority including patients aged between 60 and 80 years. Several studies have proven that a cystectomy can be performed safely in the elderly population. We sought out to review the literature identifying the specific complications and the considerations requiring attention when performing a urinary diversion on an elderly patient. A review of literature performed using PubMed revealed paucity of citations specifically looking at different urinary diversion techniques and the specific complications related in an elderly population. However, we extrapolated additional data from articles that studied cystectomy surgical cohorts with identifiable age stratification. Particular complications and areas deserving of additional attention included gastrointestinal, renal, ureteroenteric anastomotic technique, metabolic disorders, quality of life, and voiding dysfunction. Detailed history and proper counseling of the patient and family are central to the selection of the appropriate urinary diversion technique and help maintain realistic patient expectations with a higher satisfaction rate. It is of paramount importance when considering continent urinary diversions to address the feasibility of adhering to a higher level of maintenance and the patient's ability to withstand diversionrelated complications.

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Section: Voiding Function-continence and Urinary Retentionmentioning

confidence: 63%

Urinary Diversion in the Elderly

Ayoub

Westney

2015

Curr Bladder Dysfunct Rep

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“…Ureteral stricture, usually caused by hypovascularization of the ureteral end, is another common late complication after bladder substitution and is particularly related to the length of the residual ureter [11,13] ; 3D-CT gives us the possibility to better evaluate the length of the ureter and its relationship with the surrounding structures.…”

Section: Discussionmentioning

confidence: 99%

Three-Dimensional Computed Tomography of the Orthotopic Ileal Neobladder Reconstruction: Normal and Abnormal Findings

et al. 2009

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Introduction: Our study aimed to assess the usefulness of 3D-CT in patients who have undergone radical cystectomy and orthotopic ileal neobladder. Materials and Methods: We performed a CT study with 3D reconstructions in 32 patients 6 months after radical cystectomy and different orthotopic ileal neobladder (8 Studer, group A; 10 Hautmann-Ghoneim, group B; 14 Hautmann with ‘double chimney’ modification, group C). We evaluated position, shape and volume of neobladder; length of ureters and of afferent limb (in group A), length and diameter of ureteral intramural tunnel (in group B) and length of ‘chimney’ (in group C); vesico-urethral angle; vesico-ureteral reflux; possible complications. Results: In group A, we observed a renal stone with hydronephrosis, a lateral neobladder and a bilateral vesico-ureteral reflux. In 2 females of group B, neobladder was on the right side and associated in 1 case with a conical shape, hydroureteronephrosis, filling defects and urinary incontinence. In group C, 1 patient had a bilateral vesico-ureteral reflux and 1 had a left hydronephrosis. A pouchocele was detected in 1 patient with vesico-urethral angle less than 120°. Conclusions: 3D-CT is helpful for better displaying the morphology of a new reno-vesical anatomy, and some features seem to be indicative of a predisposition to develop possible complications. It may be useful for surgeons to plan a reintervention to obviate or prevent complications.

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“…Este porcentaje se mantiene estable en los 5 años siguientes a la intervención y después disminuye con el tiempo. Así la continencia se correlaciona negativamente con la edad del paciente (p<0,05) 25 . Ningún paciente precisó en su serie esfínter urinario artificial o colectores.…”

Section: Continencia Diurnaunclassified

Manejo perioperatorio y resultados en pacientes con neovejiga ileal ortotópica: Postoperative management and results

Ardura¹,

Abarca²,

Studer

2008

Actas Urol Esp

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RESUMENMANEJO PERIOPERATORIO Y RESULTADOS EN PACIENTES CON NEOVEJIGA ILEAL ORTOTÓPICA La reconstrucción del tracto urinario tras la cistectomía radical ha evolucionado desde la simple derivación urinaria hasta la reconstrucción anatómica y funcional del mismo lo más próxima posible al estado preoperatorio del paciente. En los últimos 20 años, la reconstrucción ortotópica ha pasado de cirugía experimental a ser el método preferido de derivación urinaria en ambos sexos. Los urólogos que realizan este tipo de intervención deben tener experiencia en cirugía pélvica y ser capaces de realizar una cistectomía con preservación nerviosa. Sin embargo, lo más importante en estos enfermos es el manejo postoperatorio, para lo cual se requiere un profundo conocimiento de la fisiología de la neovejiga, sus posibles complicaciones y tratamientos. Revisamos en este artículo los principales aspectos del manejo postoperatorio de los pacientes con neovejiga ileal. También se revisan los resultados de la técnica a largo plazo con respecto a continencia, función sexual, preservación de función renal, control oncológico y calidad de vida de los pacientes. ABSTRACT ORTHOTOPIC ILEAL NEOBLADDER. POSTOPERATIVE MANAGEMENT AND RESULTSUrinary diversion after cystectomy have evolved from simple diversion and protection of the upper tracts to functional and anatomic restoration as close as possible to the natural preoperative state. Over the past 15 years, orthotopic reconstruction has evolved from "experimental surgery" to the "preferred method of urinary diversion" in both sexes. Urologist that perform this technique should have an appropriate experience with pelvic surgery and be able to perform a nerve sparing radical cystectomy. Nevertheless, the postoperative management of these patients is more important than the surgical construction if good longterm results are to be achieved. For this reason, a great knowledge about the neobladder´s physiology, postoperative complications and their treatment are needed. We review the most important aspects in the postoperative management of patients with ileal neobladder. We also resume the long term outcomes concerning to continence, sexual function, renal impairment, oncologic safety and quality of life.

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Ileal Orthotopic Bladder Substitute Combined with an Afferent Tubular Segment: Long-Term Upper Urinary Tract Changes and Voiding Pattern

Cited by 43 publications

References 27 publications

Urinary Diversion in the Elderly

Urinary Diversion in the Elderly

Three-Dimensional Computed Tomography of the Orthotopic Ileal Neobladder Reconstruction: Normal and Abnormal Findings

Manejo perioperatorio y resultados en pacientes con neovejiga ileal ortotópica: Postoperative management and results

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