title: Orthotopic sigmoid vs. ileal neobladders in Japanese patients: a comparative assessment of complications, functional outcomes, and quality of life.
abstract: OBJECTIVE
  To compare the clinical outcomes of sigmoid and ileal neobladders (NBs) created following radical cystectomy.
  
  
  METHODS
  This study included 90 and 144 Japanese patients undergoing radical cystectomy and orthotopic NB reconstruction with a sigmoid and ileal segment, respectively. Postoperative clinical outcomes between the sigmoid and ileal NB groups (SNBG and INBG) were compared.
  
  
  RESULTS
  In this series, 110 early and 51 late complications occurred in 71 and 41 patients, respectively; however, there was no significant difference in the incidence of complications between SNBG and INBG. At 1 year postoperatively, there were no significant differences in the proportion of spontaneous voiders and the continence status between these 2 groups; however, despite the lack of significant differences in the maximal flow rate and voided volume, the post-void residual in SNBG was significantly smaller than that in INBG. Voiding functional outcomes at 5 years postoperatively were also obtained from 28 and 49 in SNBG and INBG, respectively. Although there were no significant changes in the functional outcomes in SNBG, the proportion of spontaneous voiders and post-void residual in INBG at 5 years postoperatively were significantly poorer than those at 1 year postoperatively. Furthermore, the postoperative health-related quality of life assessed by a Short-Form 36 survey did not show any significant differences in all 8 scores between these 2 groups.
  
  
  CONCLUSIONS
  Both types of NB reconstruction resulted in comparatively satisfactory outcomes; however, the voiding function, particularly that on long-term follow-up, in SNBG appeared to be more favorable than that in INBG.
authors.affiliation: Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan. Electronic address: hideakimiyake@hotmail.com.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Miyake
authors.forename: Junya
authors.initials: J
authors.lastname: Furukawa
authors.forename: Iori
authors.initials: I
authors.lastname: Sakai
authors.forename: Mototsugu
authors.initials: M
authors.lastname: Muramaki
authors.forename: Masuo
authors.initials: M
authors.lastname: Yamashita
authors.forename: Taka-Aki
authors.initials: TA
authors.lastname: Inoue
authors.forename: Masato
authors.initials: M
authors.lastname: Fujisawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D012809:Colon, Sigmoid / Q000503:physiopathology / Q000601:surgery*; D015653:Cystectomy / Q000379:methods*; D005260:Female; D006801:Humans; D007082:Ileum / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000503:physiopathology; D011788:Quality of Life; D011795:Surveys and Questionnaires; D001749:Urinary Bladder Neoplasms / Q000503:physiopathology / Q000601:surgery*; D016476:Urinary Reservoirs, Continent; D014554:Urination / Q000502:physiology