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.
Hou
Guo-Liang
GL
State Key Laboratory of Oncology in Southern China, Guangzhou, People's Republic of China.
Li
Yong-Hong
YH
Zhang
Zhi-Ling
ZL
Xiong
Yong-Hong
YH
Chen
Xiao-Feng
XF
Yao
Kai
K
Liu
Zhuo-Wei
ZW
Han
Hui
H
Qin
Zi-Ke
ZK
Zhou
Fang-Jian
FJ
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