Three-dimensional computed tomography of the orthotopic ileal neobladder reconstruction: normal and abnormal findings.
BACKGROUND
Our study aimed to assess the usefulness of 3D-CT in patients who have undergone radical cystectomy and orthotopic ileal neobladder.


METHODS
We performed a CT study with 3D reconstructions in 32 patients 6 months after radical cystectomy and different orthotopic ileal neobladder (8 Studer, group A; 10 Hautmann-Ghoneim, group B; 14 Hautmann with 'double chimney' modification, group C). We evaluated position, shape and volume of neobladder; length of ureters and of afferent limb (in group A), length and diameter of ureteral intramural tunnel (in group B) and length of 'chimney' (in group C); vesico-urethral angle; vesico-ureteral reflux; possible complications.


RESULTS
In group A, we observed a renal stone with hydronephrosis, a lateral neobladder and a bilateral vesico-ureteral reflux. In 2 females of group B, neobladder was on the right side and associated in 1 case with a conical shape, hydroureteronephrosis, filling defects and urinary incontinence. In group C, 1 patient had a bilateral vesico-ureteral reflux and 1 had a left hydronephrosis. A pouchocele was detected in 1 patient with vesico-urethral angle less than 120 degrees.


CONCLUSIONS
3D-CT is helpful for better displaying the morphology of a new reno-vesical anatomy, and some features seem to be indicative of a predisposition to develop possible complications. It may be useful for surgeons to plan a reintervention to obviate or prevent complications.
Clinical Department of Radiological and Histopathological Sciences, Division of Diagnostic Imaging, University of Bologna, Bologna, Italy.
Claudia
C
Sassi
Lucia
L
Santilli
Sergio
S
Concetti
Riccardo
R
Schiavina
Elena
E
Amadori
Enrico
E
Severini
Giuseppe
G
Martorana
Giuseppe
G
Battista
D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000601:surgery; D015653:Cystectomy / Q000009:adverse effects; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging / Q000209:etiology; D021621:Imaging, Three-Dimensional; D007669:Kidney Calculi / Q000000981:diagnostic imaging / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014513:Ureter / Q000000981:diagnostic imaging / Q000601:surgery; D001743:Urinary Bladder / Q000000981:diagnostic imaging* / Q000601:surgery*; D001749:Urinary Bladder Neoplasms / Q000601:surgery; D014547:Urinary Diversion / Q000009:adverse effects; D014549:Urinary Incontinence / Q000000981:diagnostic imaging / Q000209:etiology; D016476:Urinary Reservoirs, Continent / Q000009:adverse effects; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging / Q000209:etiology