Better compliance contributes to better nocturnal continence with orthotopic ileal neobladder than ileocolonic neobladder after radical cystectomy for bladder cancer.
OBJECTIVE
To investigate, in a randomized controlled study, the degree of continence after the creation of orthotopic ileocolonic and ileal neobladders after cystectomy and to explore a possible mechanism for the difference in continence between these 2 types of orthotopic neobladder.


METHODS
From 2003 to 2007, 71 male patients underwent orthotopic lower urinary tract reconstruction with either an ileocolonic or ileal neobladder after radical cystectomy. The degrees of continence and voiding patterns were individually evaluated using urodynamic examinations and a detailed patient questionnaire. The abnormal upper tract was evaluated using intravenous urography and ultrasonography.


RESULTS
Complete daytime continence was achieved in 90.9% and 89.4% of the patients and functional nocturnal continence 48.5% and 76.3% of patients in the ileocolonic neobladder and ileal neobladder groups, respectively. The urodynamic data showed that the initial volume of both the ileocolonic and the ileal neobladder appeared to not be significantly different statistically, although the compliance of the ileocolonic neobladder was lower than that of the ileal neobladder (P < .05). No difference was found in the parameters such as flow rate, urethral profile length, maximal urethral pressure, or neobladder neck pressure between the 2 neobladder types.


CONCLUSIONS
Although the ileocolonic and ileal neobladders can both achieve a large initial volume, the ileal neobladder has an advantage in the aspect of obtaining satisfactory nocturnal continence because of its greater compliance compared with that of the ileocolonic neobladder.
Chen
Zhiwen
Z
Section of Urological Oncology, Urology Institute of People Liberation Army, Southwest Hospital, Third Military Medical University, Chongqing, People's Republic of China.
Lu
Gensheng
G
Li
Xin
X
Li
Xuemei
X
Fang
Qiang
Q
Ji
Huixiang
H
Yan
Junan
J
Zhou
Zhansong
Z
Pan
Jinhong
J
Fu
Weihua
W
Li
Weibin
W
Xiong
Enqing
E
Song
Bo
B
D000368:Aged; D003106:Colon / Q000637:transplantation*; D003187:Compliance; D015653:Cystectomy; D006801:Humans; D007082:Ileum / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D016476:Urinary Reservoirs, Continent / Q000502:physiology*; D014563:Urodynamics