Urodynamic and clinical characteristics of small intestine reservoir directly connected to urethral sphincter.
Eight patients in whom a small intestine reservoir with direct anastomosis to the urethral sphincter had to be performed after radical cystectomy for invasive carcinoma of the urinary bladder, were included in the study. The function of small intestine reservoir was clinically and urodynamically monitored during 24 months postoperatively. All patients urinated per urethram, with abdominal strain or with urethral sphincter relaxation without abdominal strain. After 21 months, diurnal continence was maintained in 87.5%, and circadian continence in 75% of the patients. Urodynamic tests showed it to be a low-pressure reservoir, where the basal reservoir pressure never exceeded 30 cm H2O during filling. The values of maximal cystometric capacity showed that a certain time of reservoir maturation had to elapse after the reservoir construction. After 3-6 months, the mean maximal cystometric capacity was 250 ml, and after 9 months it was 520 ml. The proportion of continent patients was observed to rise with the increase in the small intestine reservoir capacity. We believe that three substantial issues are ensured by the described surgical technique, i.e. the antireflux mechanism, appropriate capacity and acceptable continence.
Gilja
I
I
Department of Urology, Sveti Duh General Hospital, Zagreb, Croatia.
Kovacić
M
M
Radej
M
M
D000368:Aged; D006801:Humans; D007421:Intestine, Small; D008875:Middle Aged; D001749:Urinary Bladder Neoplasms / Q000601:surgery; D016476:Urinary Reservoirs, Continent; D014554:Urination; D014563:Urodynamics