Short ileal segment for orthotopic neobladder: a feasibility study.
OBJECTIVE
The objective of this study was to present the construction of a neobladder with a modified pouch technique using 25-35 cm of terminal ileum.


METHODS
Thirty-eight patients whose pouch was constructed from 25-35 cm of terminal ileum (short pouch [SP] group) were prospectively evaluated vs 41 patients whose pouch was constructed from 50-70 cm of terminal ileum (long pouch group). Pouch volume, post-void residual (PVR) volume, need for catheterization, continence and voiding frequency were evaluated at 3 and 12 months after surgery.


RESULTS
SP group patients had significantly smaller pouch capacity (440 vs 840 mL, P < 0.001) at month 12, and smaller PVR at postoperative months 3 (11 [0-43]vs 40 [0-147] mL, P < 0.001) and 12 (10 [0-90]vs 72 [0-570] mL, P < 0.001). SP group patients had significantly higher voiding frequency on postoperative month 3 (10 vs 9, P < 0.001) and 12 (7 vs 6, P < 0.005). Continence was significantly improved in the SP group compared with the long pouch group after 12 months (63.2% vs 34.1%, respectively, P = 0.034). Full continence improved significantly over time (P < 0.001) in the SP group, from 26.3% at month 3 to 63.2% at month 12.


CONCLUSIONS
A pouch constructed from 25-35 cm of terminal ileum provides adequate capacity, smaller PVR, satisfactory continence and a better 24-h voiding frequency pattern during the first postoperative year.
Aleksic
Predrag
P
Urology Clinic, Military Medical Academy, Belgrade, Serbia. p.aleksic@yahoo.com
Bancevic
Vladimir
V
Milovic
Novak
N
Kosevic
Branko
B
Stamenkovic
Dusica M
DM
Karanikolas
Menelaos
M
Campara
Zoran M
ZM
Jovanovic
Mirko
M
D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007082:Ileum / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D014547:Urinary Diversion / Q000379:methods*; D016476:Urinary Reservoirs, Continent / Q000502:physiology; D014563:Urodynamics