title: Experience and functional outcome of modified ileal neobladder in 95 patients.
abstract: OBJECTIVE
  We took advantage of the Goodwin method to develop a modified ileal neobladder. We present the operation procedure and assessed the functional results.
  
  
  METHODS
  From April 1997 and May 2005, 95 patients (75 men and 20 women), mean age 64.6 years (range: 36-80 years) underwent orthotopic ileal neobladder replacement with application of the Goodwin method. The Le Duc technique was used for antireflux procedure. However, for the last 35 patients, antireflux procedure was not carried out. The median follow-up period was 37 months (range: 3-98 months). We reviewed the surgical outcome and complications. Continent status and urodynamic profile were also measured.
  
  
  RESULTS
  The mean operation time for the neobladder formation was 130 mins (range: 65-285 mins). There were no perioperative deaths. Leakage from the ileourethral anastomosis leak was found in four patients (4.2%), wound infection in nine patients (9.5%), ileal anastomosis leak in two patients (2.1%) and paralytic ileus in two patients. No hydronephrosis, neobladder-ureteral reflux or deterioration of renal function was seen. The maximum neobladder pressure was 21 +/- 13 cm (mean +/- SD) at 6 months and 12 +/- 11 cm at 12 months after surgery. The neobladder capacity was 293 +/- 118 mL at 6 months and 312 +/- 85 mL at 12 months after surgery. Of the 95 patients, 87 (91.6%) maintained complete dryness day and night.
  
  
  CONCLUSIONS
  These results suggest that the present orthotopic ileal neobladder is simple to be carried out and achieves acceptable voiding function. Longer observation for neobladder and upper urinary tract function is necessary.
authors.affiliation: Department of Urology, Hirosaki University School of Medicine, Hirosaki 036-8562, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Koie
authors.forename: Shingo
authors.initials: S
authors.lastname: Hatakeyama
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yoneyama
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Ishimura
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamato
authors.forename: Chikara
authors.initials: C
authors.lastname: Ohyama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods*; D016476:Urinary Reservoirs, Continent / Q000502:physiology*; D014554:Urination / Q000502:physiology*; D014563:Urodynamics