title: The Studer orthotopic neobladder: long-term (more than 10 years) functional outcomes, urodynamic features, and complications.
abstract: OBJECTIVE
  Radical cystectomy and urinary diversion are the standard treatment for invasive bladder cancer. We analyzed the long-term (>10 years postoperatively) functional outcomes, complications, and urodynamic findings in a single center series of patients who underwent cystectomy and a Studer ileal neobladder substitution.
  
  
  METHODS
  A retrospective chart review of 108 Studer pouches constructed during 1990 and 2011 was performed. Data were analyzed in terms of long-term (>10 years) outcomes. Complications, incontinence, voiding difficulties, upper urinary tract changes, overall satisfaction, and urodynamic findings of the reservoir were obtained.
  
  
  RESULTS
  We evaluated 19 out of 50 patients who had lived for over 10 years postoperatively. Another 31 patients were not traced: 7 patients died following recurrence, 15 died due to exacerbation of a comorbidity, and 9 patients were lost to follow-up. Concerning complications, 6 patients had an atrophied kidney, 5 patients had moderate hydronephrosis, 5 patients had chronic recurrence of pylelonephritis, and 2 patients had voiding difficulty because of bladder neck stricture due to clean intermittent catheterization. One patient underwent an operation due to intestinal obstruction. Seven patients had incontinence; all 7 patients showed intermittently at night and 2 patients even in waking hours. Maximum bladder capacity was 484.1±119.2 mL, maximum flow rate was 13.6±9.7 mL/sec, and post-void residual urine volume was 146.8±82.7 mL.
  
  
  CONCLUSIONS
  Long-term outcomes with the Studer orthotopic ileal neobladder have an acceptable complication rate and good functional results. However, potential adverse outcomes such as renal deterioration, dysfunctional voiding should also be considered.
authors.affiliation: Department of Urology, Research Institute for Convergence of Biochemical Science and Technology, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, 20 Geumo-ro, Mulgeum-eup, Yangsan 626-770, Korea.
authors.forename: Jong Kil
authors.initials: JK
authors.lastname: Nam
authors.forename: Tae Nam
authors.initials: TN
authors.lastname: Kim
authors.forename: Sung Woo
authors.initials: SW
authors.lastname: Park
authors.forename: Sang Don
authors.initials: SD
authors.lastname: Lee
authors.forename: Moon Kee
authors.initials: MK
authors.lastname: Chung
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000601:surgery; D008297:Male; D017060:Patient Satisfaction; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000601:surgery; D014547:Urinary Diversion / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D016476:Urinary Reservoirs, Continent / Q000009:adverse effects; D014563:Urodynamics
keywords: Urinary diversion; cystectomy; urinary bladder neoplasms
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