title: A three-centre experience of orthotopic neobladder reconstruction after radical cystectomy: revisiting the initial experience, and results in 104 patients.
abstract: OBJECTIVE
  To assess, in a retrospective three-centre series, a second analysis of the initial experience and results of patients undergoing radical cystectomy (RC) and orthotopic neobladder reconstruction (ONR) after an additional 4 years of follow-up.
  
  
  METHODS
  The medical records of 104 suitable consecutive patients undergoing RC and ONR between June 1994 and April 2003 were reviewed retrospectively. The complications, mortality, continence and cancer control rates were all recorded.
  
  
  RESULTS
  The median (range) follow-up was 88 (52-156) months; 90 patients had reconstruction with a 'Studer' neobladder, 12 with a Hautmann W pouch and 2 with a 'T pouch' ileal neobladder. There were 24 early complications, and one death after surgery. There were 32 late complications. The daytime continence rate was 98% and the nocturnal continence rate was 76%. Ten patients required intermittent self-catheterization (ISC). In all, 30 patients had local and/or distant recurrences, all of whom died. Seven patients died from other causes.
  
  
  CONCLUSIONS
  ONR provides excellent long-term continence rates and both acceptable complication and mortality rates. Suitable patients undergoing RC should be offered ONR.
authors.affiliation: Harold Hopkins Department of Urology, Royal Berkshire Hospital, Reading, UK. jpmeyer@doctors.org.uk
authors.forename: Jon-Paul
authors.initials: JP
authors.lastname: Meyer
authors.forename: Christopher
authors.initials: C
authors.lastname: Blick
authors.forename: Nimalan
authors.initials: N
authors.lastname: Arumainayagam
authors.forename: Katrina
authors.initials: K
authors.lastname: Hurley
authors.forename: David
authors.initials: D
authors.lastname: Gillatt
authors.forename: Rajendra
authors.initials: R
authors.lastname: Persad
authors.forename: Derek
authors.initials: D
authors.lastname: Fawcett
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy / Q000009:adverse effects / Q000379:methods*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D012008:Recurrence; D016896:Treatment Outcome; D001745:Urinary Bladder Diseases / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods*; D016476:Urinary Reservoirs, Continent