Sigmoid orthotopic neobladder after radical cystectomy for bladder tumour: an Indian experience.
OBJECTIVE
To determine the long-term results of constructing a sigmoid neobladder after radical cystectomy for transitional cell carcinoma (TCC) of the urinary bladder.


METHODS
The study included 170 patients with TCC of the bladder and a normal sigmoid colon. After radical cystectomy the neobladder was formed by completely detubularizing an isolated sigmoid colon segment. Subsequently patients were followed by clinical, biochemical, radiological and urodynamic assessments.


RESULTS
Four patients died soon after surgery; the neobladder-related delayed complications were death in three patients, loss of five renal units, and electrolyte imbalance in five patients. Uretero-intestinal anastomotic narrowing was another frequent delayed complication. Most (97%) patients had nocturnal incontinence, and most voided with a good stream with a minimal postvoid residual urine volume.


CONCLUSIONS
The sigmoid neobladder, despite some limitations, is the best option for diverting urine after radical cystectomy.
Yadav
Sher Singh
SS
Department of Urology, S.M.S. Medical College, Jaipur, Rajasthan, India. drssyadav@hotmail.com
Sadadukhi
Trilok Chand
TC
Sharma
Krishnan Kumar
KK
Yadav
Ram Gopal
RG
Mathur
Rajeev
R
D000328:Adult; D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D012809:Colon, Sigmoid / Q000601:surgery*; D015653:Cystectomy / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D053206:Nocturnal Enuresis / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods*; D016476:Urinary Reservoirs, Continent; D014563:Urodynamics