The "I-Pouch": Results of a new ileal neobladder technique.
OBJECTIVE
The aim of this study was to investigate perioperative, oncological and functional outcomes of the "I-Pouch" neobladder.


METHODS
From 2002 to 2011, 97 patients (72 men, 25 women, median age 65, range 42-84 years) underwent radical cystectomy with I-Pouch neobladder reconstruction. Complications were graded according to the Clavien-Dindo classification. Oncological and functional outcomes were assessed. The median oncological and functional follow-up was 41 months (range 3-107 months) and 18 months (3-111 months), respectively.


RESULTS
In the total cohort, the 5 year cancer-specific survival was 67.9%. The major 30 and 90 day complication rates were 14.4% and 17.5%, respectively. Open reimplantation for ureterointestinal stricture was necessary in two (2.1%). Of the 95 functionally evaluable patients postoperatively, 93 urinated spontaneously (97.9%) and two patients (2.1%) required clean intermittent catheterization to empty their neobladder. The median postvoid residual urine volume (PVR) was 0 ml (range 0-200 ml). One patient had postoperative reflux (1%), as evidenced by voiding cystography. The median number of urinary tract infections per year was 0 (range 0-2) and showed no association with increased PVR (p = 0.18).


CONCLUSIONS
The perioperative, oncological and functional outcomes of the I-Pouch are comparable to those of other types of ileal neobladder. An advantage of the I-Pouch is that the implantation of the ureters lies on the neobladder floor, which facilitates later instrumentation of the upper tract.
a 1 Department of Urology, University Hospital Tübingen , Tübingen, Germany.
Georgios
G
Gakis
a 1 Department of Urology, University Hospital Tübingen , Tübingen, Germany.|b 2 Department of Urology, Assiut University Hospital , Assiut, Egypt.
Mohamed F
MF
Abdelhafez
a 1 Department of Urology, University Hospital Tübingen , Tübingen, Germany.
Arnulf
A
Stenzl
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D039021:Colonic Pouches; D015653:Cystectomy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000601:surgery*; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D014547:Urinary Diversion / Q000009:adverse effects / Q000379:methods*; D016476:Urinary Reservoirs, Continent; D014563:Urodynamics
Functional; I-Pouch; ileal; neobladder; oncological; orthotopic bladder substitution; perioperative; upper urinary tract