Indication and functional outcome of orthotopic neo-bladder reconstruction following radical cystectomy for bladder cancers in a specialist hospital in north-west Cameroon

Abstract

Background Radical cystectomy (RC) and urinary diversion are treatment modalities for muscle invasive bladder cancer (MIBC). However, in Cameroon, there is little information on orthotopic neo-bladder (ONB) reconstruction in the literature. Objective We aimed to share our indications for ONB reconstruction, evaluate the functional outcomes, and enumerate the surgical complications. By sharing our experience with ONB reconstruction, we hope to broaden the understanding of this procedure and aid in anticipating its various outcomes. Methods A retrospective assessment of medical records was conducted for all patients who underwent ONB reconstruction after RC for bladder cancer from January 2020 to April 2023 at Nkwen Baptist Hospital. Data collected included socio-demographic details, clinical and pathological data, indications for surgery, voiding, and metabolic outcomes at 6 and 12 months postoperatively. Data analysis was performed using IBM-SPSS version 26.0. Results Eighteen patients (66.7% male) with a mean age of 60.50 (± 6.90) years were included. Indications for ONB were 56% for pT2b, 23% for pT2a, and 23% for multifocal T1 disease without ureteral, urethral, or bladder neck extension. At 12 months, 77.8% had acceptable diurnal continence, and 72.2% had acceptable nocturnal continence. Peak urinary flow rates and post-void residual volumes were acceptable in 77.8% and 83.3% of patients, respectively. Additionally, 88.9% had normal sodium levels, 94.4% had normal potassium levels, and 94.4% had normal chloride levels at 12 months post-ONB creation. Conclusions ONB reconstruction provides satisfactory continence and minimal rates of electrolyte derangement, contributing valuable insights into the functional outcomes of this procedure.