[Bladder replacement by enterocystoplasty after total cystectomy].
From May 1987 to April 1988, 7 male patients, 43-69 years old in age, underwent enterocystoplasty after total cystectomy. In 5 of them, a selected intestinal segment, consisted of the terminal portion of the ileum, the cecum and the proximal part of the ascending colon, was freed and detubularized for construction of "bladder" substitution. In the remaining two patients with a previous history of cholecystectomy, having severe intestinal adhesions, the ileum or the sigmoid-colon were used. At 3 months after operation, 6 patients had a vesical capacity of 300 ml or more and the maximum volume of urine excreted at one voiding was 200 ml or more. Daytime continence had been achieved in 6 patients at 3 months after operation, whereas nighttime continence had been achieved in 5 patients at 6 months after operation. Serum electrolytes, pH value of arterial blood and renal function, were all normal during the follow-up period (5-13 months). Potency was preserved in 2 patients. All the patients, except one whose "bladder" was constructed with ileum and who was performing daily intermittent selfcatheterization, were able to enjoy almost the same activity of daily life as before operation. The final shape of the "bladder" and its position in the pelvic space seemed to be an important factor for the "bladder" function after operation. By our hand, however, postoperative cystogram revealed a sigmoid shape in all cases, though the reservoirs had an oval shape at the time when they had been constructed.(ABSTRACT TRUNCATED AT 250 WORDS)
Tobisu
K
K
Tanaka
Y
Y
Takai
K
K
Kakizoe
T
T
D000328:Adult; D000368:Aged; D006801:Humans; D007422:Intestines / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D001743:Urinary Bladder / Q000503:physiopathology / Q000601:surgery*; D001749:Urinary Bladder Neoplasms / Q000601:surgery; D014547:Urinary Diversion / Q000379:methods*; D014554:Urination