title: Real-time MRI of orthotopic ileal neobladder voiding: preliminary findings.
abstract: OBJECTIVE
  The purpose of this preliminary study was to analyze the dynamic changes in the configuration of the neobladder and naïve bladder during voiding using real-time MRI.
  
  
  METHODS
  This study included 10 male patients who had a radical cystectomy and an ileal orthotopic neobladder due to organ-confined bladder cancer and had good urinary function, and 5 male control volunteers. With the subjects in the lateral decubitus position, real-time MRI was performed during micturition. A sagittal slice orientation was used to depict the bladder and the entire length of the urethra; individual movements along the X-axis and Y-axis of the bottom and top of the neobladder and the naïve bladder were recorded and analyzed. Urodynamic studies (UDS) and video voiding cystourethrography were performed in patients.
  
  
  RESULTS
  Five of the 10 neobladder patients could void in the lateral decubitus position. In normal controls and patients who could void, the bladder outlet bladder moved ventrocranially during micturition. The ileal bladder outlet moved a significantly longer distance than the naïve bladder during micturition (X-axis, -13.4+/-1.5 vs. -3.6+/-4.3 cm, p=0.0014; Y-axis, -10.6+/-0.5 vs. -2.0+/-6.5 cm, p=0.0187). The distance that the bladder top moved between the naïve bladders and the neobladder did not differ. UDS did not show a difference between patients who could and could not void at lateral position.
  
  
  CONCLUSIONS
  During micturition, the neobladder was found to rotate and move more dynamically than the naïve bladder. Real-time MRI is useful for assessing dynamic voiding function of orthotopic neobladders.
authors: Department of Urology, Teikyo University, Tokyo 173-8605, Japan.
authors: Satoru
authors: S
authors: Muto
authors: Yutaka
authors: Y
authors: Kamiyama
authors: Hisamitsu
authors: H
authors: Ide
authors: Hiroshi
authors: H
authors: Okada
authors: Keisuke
authors: K
authors: Saito
authors: Kojiro
authors: K
authors: Nishio
authors: Shino
authors: S
authors: Tokiwa
authors: Tatsuro
authors: T
authors: Kaminaga
authors: Shigeru
authors: S
authors: Furui
authors: Shigeo
authors: S
authors: Horie
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D015653:Cystectomy; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D001749:Urinary Bladder Neoplasms / Q000503:physiopathology / Q000601:surgery; D016476:Urinary Reservoirs, Continent / Q000502:physiology*; D014554:Urination / Q000502:physiology*; D014563:Urodynamics