title: Modified ileal neobladder for continent urinary diversion: functional results after 9 years of experience.
abstract: OBJECTIVE
  We report the continence status and urodynamic findings in 59 patients who underwent radical cystectomy and orthotopic bladder reconstruction using a modified S-ileal neobladder technique between January 1993 and July 2002.
  
  
  METHODS
  Continence status was assessed using patient interview, frequency-volume charts and the need for protective devices. Reservoir sensation, compliance, capacity and activity were assessed by enterocystometry. Post-void residual urine volume greater than 100 ml was the indication for clean intermittent self-catheterization.
  
  
  RESULTS
  Daytime continence was reported by 95.5% and 100% of our patients at 1 and 5 years, respectively. Overall, 77.7% of patients reported nighttime continence at 1 year and 96.5% at 5 years. The need for a protective device decreased with time and most of the patients would have undergone the operation again. Enterocystometric capacity and maximum reservoir pressure remained remarkably stable at 391.6 versus 440 ml, and 30 versus 20 cm H2O, 6 months and 5 years after surgery, respectively. Nevertheless, median post-void residual urine volume increased from 35 ml at 6 months to 55 ml at 5 years with an increase in prevalence of patients requiring intermittent self-catheterization due to post-void residual urine greater than 100 ml from 1.8% at 6 months to 10% at 5 years.
  
  
  CONCLUSIONS
  Orthotopic bladder substitution with the modified S-ileal neobladder technique has an excellent functional outcome over time, resulting in high daytime and nighttime continence levels as well as high acceptability rates from our patients.
authors.affiliation: 2nd Department of Urology, University of Athens, Sismanoglio Hospital, Athens, Greece.
authors.forename: Andreas
authors.initials: A
authors.lastname: Skolarikos
authors.forename: Charalambos
authors.initials: C
authors.lastname: Deliveliotis
authors.forename: Eugenios
authors.initials: E
authors.lastname: Alargof
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Ferakis
authors.forename: Vasilios
authors.initials: V
authors.lastname: Protogerou
authors.forename: Constantin
authors.initials: C
authors.lastname: Dimopoulos
mesh_terms: D000368:Aged; D006801:Humans; D007082:Ileum / Q000601:surgery; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome; D014547:Urinary Diversion / Q000379:methods*; D016476:Urinary Reservoirs, Continent / Q000502:physiology*; D014554:Urination; D014563:Urodynamics