Creation of an ileocolic bladder after cystectomy.
A divided segment of ileum and colon is used to create a neobladder after cystectomy with a cecourethral anastomosis to provide volitional voiding with continence. Such a bladder provides for good sensation with a large low pressure reservoir and an antireflux ureteral anastomosis. The standard nerve-sparing cystoprostatectomy is performed and no segment of the bladder or prostate is left to compromise the cancer operation. In female or male patients with diffuse carcinoma in situ a similar reservoir with a plicated ileocutaneous anastomosis also can provide continence with intermittent catheterization. Four patients with a urethral anastomosis have day and nighttime continence, and 2 with a cutaneous stoma have 4 to 5-hour dry intervals. Ultimately, it is possible for a patient to void with good urinary control and to have sexual function after cystectomy.
Marshall
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James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland.
D000328:Adult; D002295:Carcinoma, Transitional Cell / Q000601:surgery; D003106:Colon / Q000601:surgery; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy; D001743:Urinary Bladder / Q000601:surgery*; D001749:Urinary Bladder Neoplasms / Q000601:surgery; D014547:Urinary Diversion / Q000379:methods*