A modified technique for neourethral anastomosis in orthotopic neobladder reconstruction.
OBJECTIVE
To introduce a modified technique for urethral anastomosis in orthotopic neobladder reconstruction.


METHODS
Between January 2002 and August 2008, about 141 consecutive patients (130 men and 11 women) underwent total cystectomy and orthotopic neobladder reconstruction in which a modified technique was used to anastomosed the caudal-most part of the intestinal neobladder directly to the urethral remnant. The emptying of the neobladder, the early and late complications at the urethral anastomosis was evaluated.


RESULTS
Mean patient age at surgery was 58.4 years (range, 33-83) and median follow-up was 42 months (range, 4-83 months). Early urine leakage at the vesicourethral anastomosis developed in 1 patient, and was cured by extending catheter drainage. A total of 138 patients had good emptying of the neobladder, with residual urine volume < 50 mL. Three patients had residual urine volume > 100 mL, and achieved good emptying after intermittent catheterization once a week for 6-12 months. No late complications occurred at the urethral anastomosis site. Daytime continence was good or satisfactory in 97.0% of patients and night-time continence was good or satisfactory in 88.5% of patients.


CONCLUSIONS
The clinical outcome of our modified technique for urethral anastomosis in orthotopic neobladder substitution was excellent, but the advantage of this technique needs prospective controlled study.
State Key Laboratory of Oncology in Southern China, Guangzhou, People's Republic of China.
Guo-Liang
GL
Hou
Yong-Hong
YH
Li
Zhi-Ling
ZL
Zhang
Yong-Hong
YH
Xiong
Xiao-Feng
XF
Chen
Kai
K
Yao
Zhuo-Wei
ZW
Liu
Hui
H
Han
Zi-Ke
ZK
Qin
Fang-Jian
FJ
Zhou
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000379:methods; D015653:Cystectomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014521:Urethra / Q000601:surgery*; D001749:Urinary Bladder Neoplasms / Q000601:surgery; D016476:Urinary Reservoirs, Continent; D013520:Urologic Surgical Procedures / Q000379:methods