The impact of a modified ileal neobladder on the lifestyle and voiding patterns in Asian patients.
OBJECTIVE
To evaluate the impact of the modified ileal neobladder reconstruction on lifestyle, voiding habits and functional outcome in Asian patients.


METHODS
Twenty-seven Asian patients (25 men and two women, mean age 59 years, range 41-76) underwent modified ileal neobladder reconstruction after radical cystectomy for carcinoma of the bladder. The mean (range) follow-up was 21 (3-75) months. All patients were evaluated retrospectively using case notes, reviews, interviews and voiding charts; 18 patients underwent urodynamic studies.


RESULTS
Twenty-five patients (93%) achieved diurnal and 23 (85%) nocturnal continence within 6 months. Of the 19 patients who were in employment before surgery, 15 continued to be economically active afterward; 26 patients (96%) reported no change in their daily living activities. Of 16 men who reported being potent pre-operatively only four retained some residual erectile function. Twenty-three patients were interviewed about their voiding habits and satisfaction with the outcome of surgery. Fourteen patients had no sensation of reservoir fullness and of the 21 men, 13 had to squat or sit to void effectively. The mean (range) voiding frequency was 5 (4-8) during the day and 2 (0-4) during sleep. Twenty-two patients were satisfied with the overall outcome.


CONCLUSIONS
The modified ileal bladder provides a high urinary continence rate with minimal changes in daily living activities and occupational status. The functional outcome was very satisfactory and accepted well, despite some changes in reservoir sensation, voiding posture and erectile function. The method is a viable option for reconstruction after cystectomy in Asian patients.
Lee
K T
KT
Department of Urology, Sultanah Aminah Hospital, Johore Bahru, Johore, Malaysia.
Li
M K
MK
Cheng
W S
WS
Foo
K T
KT
D000328:Adult; D000368:Aged; D001208:Asia / Q000208:ethnology; D015653:Cystectomy / Q000009:adverse effects / Q000379:methods* / Q000523:psychology; D007172:Erectile Dysfunction / Q000209:etiology; D005260:Female; D006801:Humans; D007082:Ileum / Q000637:transplantation; D008019:Life Style; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012846:Singapore / Q000453:epidemiology; D016019:Survival Analysis; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000208:ethnology / Q000523:psychology / Q000601:surgery*; D014547:Urinary Diversion / Q000009:adverse effects / Q000523:psychology; D016476:Urinary Reservoirs, Continent / Q000009:adverse effects; D014555:Urination Disorders / Q000209:etiology