[Hautmann's ileal neobladder: experience of 37 cases].
Between April 1993 and August 1995, a Hautmann's ileal neobladder was created in 37 men after total cystectomy for bladder cancer. Ureteroileostomy was performed using a submucosal tunnel instead of the Le-Duc Camey procedure. There was no operative mortality and only a few early complications. The mean postoperative follow-up time was 16 months, with a range of 3 to 31 months. Hydronephrosis occurred in 3 patients, being caused by stenosis at the uretero-ileo anastomosis in 2 and by proximal stenosis in 1. Neobladder-ureteral reflux did not occur in any of the patients. Postoperative ileus developed in 3 patients, and one required laparotomy. Stenosis of the urethro-ileal anastomosis developed in 3 patients, who were successfully treated by transurethral incision. Thirty five patients achieved daytime continence, while 2 patients had slight incontinence. Twenty nine patients achieved nighttime continence, and most of the patients awoke 1-4 times to prevent overflow incontinence. The mean maximum flow rate, average flow rate and post-voiding residual urine volume were respectively 15.3 ml/sec, 5.5 ml/sec and 81 ml at 6 months postoperatively, and 14.9 ml/sec, 5.4 ml/sec and 76 ml at 12 months. Four patients with more than 100 ml of residual urine required sterile intermittent catheterization 2-4 times a day. Urethral recurrence was detected in 2 patients. One was treated with transurethral resection and cisplatinum-based systemic chemotherapy, and the other required urethrectomy and urinary diversion using a new continent efferent limb.
Katoh
N
N
Department of Urology, Komaki Shimin Hospital.
Ono
Y
Y
Sahashi
M
M
Kinukawa
T
T
Matsuura
O
O
Oshima
S
S
D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D007082:Ileum / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D016476:Urinary Reservoirs, Continent / Q000379:methods*