[Orthotopic bladder replacement: I. Physiopathology of orthotopic bladder replacement with intestine].
OBJECTIVE
To analyze the physiopathological principles of utilizing the bowel for orthotopic bladder substitution and their effects on metabolism, function and continence.


METHODS
The world literature is reviewed and our experience of 100 cases is described in the third part of this study.


CONCLUSIONS
To reduce the metabolic changes, utilization of colonic or ileal segments with a maximum length of about 40 cm is advocated. This length of detubulized intestinal segment permits creating an ample, low pressure reservoir with an antireflux mechanism. The precise incidence of neoplastic degeneration of the ileal and colonic reservoirs is not known, but appears to be lower for the ileal neobladder.
Errando Smet
C
C
Servicio de Urología, Fundación Puigvert, Barcelona, España.
Regalado Pareja
R
R
Huguet Pérez
J
J
Xavier Lima
B
B
Chéchile Toniolo
G
G
Villavicencio Mavrich
H
H
D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism; D007422:Intestines / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D016476:Urinary Reservoirs, Continent / Q000379:methods*