title: Continent urinary reservoirs.
abstract: We report our experience of 30 continent urinary reservoirs (CURs) after radical cystectomy. The patients ranged in age from 35 to 70 years. There were 22 males and 8 females. Pre-operative urograms showed normal upper tracts in 22 patients, unilateral hydronephrosis in 4 and bilateral hydronephrosis in 4. The first 20 patients had a standard CUR procedure and the last 10 had a modified CUR. The mean operative time, blood loss and post-operative stay were 6.6 h, 900 ml and 25 days respectively for standard CURs and 5.7 h, 825 ml and 21 days respectively for the modified CURs. Post-operative, urinary leaks from the caecostomy site occurred in 2 patients (1 of which was fatal) while 3 other patients had prolonged ileus, burst abdomen and intestinal obstruction probably due to non-demonstrable urinary leaks. All 5 complications occurred in the first 20 patients. Upper tract status was evaluated in 28 patients 3 months after surgery and showed normal upper tracts in 19 patients, improvement in 6 (35%) and worsening in 3 (12.5%). Pouchograms showed no reflux in 25 patients, unilateral reflux in 2 and bilateral reflux in 1. Complete continence was achieved in 25 patients--2 of them had revision surgery, giving a success rate of 89% with a follow-up of 6 to 48 months (median 24). The remaining 3 patients were incontinent.
authors.affiliation: Genitourinary Service, Tata Memorial Hospital, Parel, Bombay, India.
authors.forename: J N
authors.initials: JN
authors.lastname: Kulkarni
authors.forename: H B
authors.initials: HB
authors.lastname: Tongaonkar
authors.forename: R
authors.initials: R
authors.lastname: Ravi
authors.forename: M R
authors.initials: MR
authors.lastname: Kamat
mesh_terms: D000328:Adult; D000368:Aged; D015653:Cystectomy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D014547:Urinary Diversion; D016476:Urinary Reservoirs, Continent / Q000379:methods*