title: Orthotopic bladder replacement in women: focus on functional results of a retrospective, single-centre study.
abstract: OBJECTIVE
  The aim of this study was to investigate the functional and oncological outcomes of orthotopic neobladders in women with urothelial cancer.
  
  
  METHODS
  From 1993 to 2007, 61 women underwent radical cystectomy and orthotopic ileal neobladder using the hemi-Kock pouch or Skinner T pouch. Sixteen of them were excluded owing to a lack of available follow-up data. Finally, 39 women with diagnosed TCC were included in this retrospective study. Demographic data, functional outcome including micturition characteristics such as voided volume, continence situation, use of clean intermittent catheterization (CIC), residual urine volume and recurrence rate were collected 3, 6 and >12 months after surgery.
  
  
  RESULTS
  Tumours were non-muscle-invasive in 13 patients (pT1; 32.8%) with isolated carcinoma in situ (after failure of bacillus Calmette-Guérin) in five patients (13.0%) and muscle-invasive in 19 patients (pT2-3; 49.0%), extensive superficial bladder cancer was shown in one patient (2.6%), and remaining dysplasia after transurethral resection of the bladder for T1 G2 in one patient (2.6%). Median follow-up was 37 (range 3-165) months. Day-time (71.4%) and night-time (67.8%) continence (0-1 pad/24 h) 3 months postoperatively increased to 83.8% on long-term follow-up. Clean intermittent self-catheterization was required by 20%. At a mean follow-up of 39.5 (8-86) months, two women experienced local recurrence (septum rectovaginale, pelvic floor), urethral recurrence was seen in 5.2% and distant metastasis (pulmonary, peritoneal carcinosis) also in 5.2%.
  
  
  CONCLUSIONS
  Orthotopic bladder replacement is an efficient option in appropriately selected women undergoing radical cystectomy, with encouraging functional outcome and low urethral recurrence rates, similar to published literature in men.
authors.affiliation: Department of Urology, Medical University of Innsbruck , 6020 Innsbruck, Austria.
authors.forename: Renate
authors.initials: R
authors.lastname: Pichler
authors.forename: Florian
authors.initials: F
authors.lastname: Zangerl
authors.forename: Nicolai
authors.initials: N
authors.lastname: Leonhartsberger
authors.forename: Brigitte
authors.initials: B
authors.lastname: Stöhr
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Horninger
authors.forename: Hannes
authors.initials: H
authors.lastname: Steiner
mesh_terms: D000328:Adult; D000368:Aged; D001187:Artificial Organs; D015653:Cystectomy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D018579:Patient Selection; D012189:Retrospective Studies; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000601:surgery*; D001749:Urinary Bladder Neoplasms / Q000601:surgery*