title: [Voiding function and sexual activity in patients following Hautmann neobladder construction].
abstract: OBJECTIVE
  We retrospectively evaluated the outcome of Hautmann neobladder reconstruction in terms of complications, lower urinary tract symptoms, and sexual function in a large group of patients who underwent radical cystectomy.
  
  
  METHODS
  We reviewed the medical records of 118 patients (105 men and 13 women) who underwent radical cystectomy and Hautmann neobladder construction at the Gifu University Hospital or one of its affiliate hospitals between Jan 1993 and Dec 1999. The 118 patients were asked to complete a questionnaire regarding lower urinary tract symptoms and sexual activity, and the data was compiled.
  
  
  RESULTS
  The mean follow-up period was 50.4 months (range, 6.8-88.2). Early complications comprised wound infection (in 17.8% of patients) and ileus (in 10.1% of patients). Late complications comprised ileus, pyelonephritis, stone, and stricture of the pouch-urethral anastomosis, each of which occurred in 3.4% of patients. Eighty-one (73 men and 8 women, 72.9%) of 90 surviving patients replied to the questionnaire. Seventy-seven (95.1%) of these patients reported spontaneous micturition, whereas 4 (4.9%) patients required intermittent self-catheterization. The mean total I-PSS was 11.6 points. Twenty-five percent of patients experienced interrupted voiding almost always; 38% of patients did not experience this at all. Approximately 26% of patients experienced weak urinary streams; 36% did not. Daytime continence was achieved in 97.3% of patients; nighttime incontinence was present in 61.3%. Preoperatively, 79.7% of the men were capable of sexual intercourse. Postoperatively, 63.6% of men who underwent radical cystectomy with the nerve-sparing procedure were capable of sexual intercourse, whereas only 14.8% of men who underwent radical cystectomy without the nerve-sparing procedure were.
  
  
  CONCLUSIONS
  Morbidity rates were acceptable and functional outcome was excellent in this rather large group of patients who underwent Hautmann neobladder construction. Some problems have not been fully overcome, however, i.e., nocturnal incontinence and sexual dysfunction.
authors.affiliation: Department of Urology, Gifu Prefectural Hospital, Gifu, Japan.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Taniguchi
authors.forename: Kosei
authors.initials: K
authors.lastname: Miwa
authors.forename: Toshimi
authors.initials: T
authors.lastname: Takeuchi
authors.forename: Syunsuke
authors.initials: S
authors.lastname: Sakai
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ishihara
authors.forename: Takashi
authors.initials: T
authors.lastname: Deguchi
authors.forename: Shin-ichiro
authors.initials: S
authors.lastname: Yamada
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Ito
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Ban
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Minoshima
authors.forename: Masanobu
authors.initials: M
authors.lastname: Horie
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Tamaki
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Maeda
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Harada
authors.forename: Kanhin
authors.initials: K
authors.lastname: Tei
authors.forename: Kazuya
authors.initials: K
authors.lastname: Yuhara
authors.forename: Ikuo
authors.initials: I
authors.lastname: Shinoda
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Nagatani
authors.forename: Seiji
authors.initials: S
authors.lastname: Matsuda
authors.forename: Manabu
authors.initials: M
authors.lastname: Okano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012723:Sex; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000503:physiopathology / Q000601:surgery; D014547:Urinary Diversion / Q000379:methods*; D014549:Urinary Incontinence / Q000453:epidemiology; D014554:Urination