Causes and treatment of residual urine volume after orthotopic bladder replacement in women.
OBJECTIVE
Intact innervation of the female urethra is conditional for normal urination. In the past, urethrectomy was performed as part of cystectomy. After intense anatomical studies of the female pelvis, urethral-function-sparing cystectomy was developed.


METHODS
Our clinical group consists of 41 female patients who were operated from 1993 to 1998 for bladder cancer, utilizing cystectomy with orthotopic bladder replacement.


RESULTS
In 28 patients, complete daytime continence was restored and in 13 patients, daytime continence was socially satisfactory (1-2 pads were used due to mild stress incontinence). The drawback of orthotopic replacements in females is the frequent development of serious residual volume, which was seen in one third of the 41 patients. The functional results of orthotopic neobladders and therapy of residual urine volume were documented using urodynamic studies.


CONCLUSIONS
Postvoiding residual volume may be caused by isolated dysfunction of the urethra and can be treated with clean intermittent self-catheterization or with alpha-blockers, which improve evacuation of the neobladder.
Jarolím
L
L
Department of Urology, General Faculty Hospital, 1st Medical Faculty, Charles University, Prague, Czech Republic. landislav.jarolim@lfl.cuni.cz
Babjuk
M
M
Pecher
S M
SM
Grim
M
M
Nanka
O
O
Tichý
M
M
Hanus
T
T
Janský
M
M
D000328:Adult; D000368:Aged; D015653:Cystectomy; D005260:Female; D006801:Humans; D008875:Middle Aged; D014521:Urethra / Q000294:innervation; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods*; D016476:Urinary Reservoirs, Continent; D014556:Urine; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000379:methods