[Urinary diversions and bladder replacement surgery: evolution, current situation and long-term outcomes].
Nowadays, radical cystectomy represents the first choice of therapy for muscle invasive bladder cancer. The first choice after radical cystectomy, both in male and in female patients, is no more urinary diversion, but bladder replacement surgery through orthotopic reconstruction. The ileal conduit is considered a safe procedure and the gold standard to which newer forms of urinary diversion should be compared, although few long-term results are known. Currently, neobladder is the most important urinary diversion in the world, followed by Bricker's ileal conduit. We evaluated the long-term results of the most important forms of urinary diversions, analyzing some data available in the Literature. Then, we focused our attention on long-term outcomes of our "Y Neobladder": functional outcome and long-term complications. At last, we critically examined the widely accepted notion that patients undergoing "Y Neobladder" experience superior quality of life outcomes than patients receiving an ileal conduit.
Divisione Universitaria di Urologia 2 - AOU San Giovanni Battista Molinette, Torino - Italy. dario.fontana@unito.it
Dario
D
Fontana
Andrea
A
Buffardi
Paolo
P
Destefanis
D015653:Cystectomy; D006801:Humans; D011788:Quality of Life; D001749:Urinary Bladder Neoplasms / Q000601:surgery; D014547:Urinary Diversion; D016476:Urinary Reservoirs, Continent