title: Orthotopic diversion after cystectomy in women: A single-centre experience with a 10-year follow-up.
abstract: OBJECTIVE
  To evaluate and update the clinical and surgical outcome of orthotopic diversion in an eligible cohort of women with bladder carcinoma.
  
  
  METHODS
  From 1999 to 2010, 78 women (mean age 42.4 years) had a radical cystectomy (RC) with orthotopic diversion using ileal neobladder reconstruction to treat invasive bladder carcinoma. The mean (SD) follow-up was 62 (25) months.
  
  
  RESULTS
  The histopathological pattern was squamous cell carcinoma in 52 (67%) patients, transitional cell carcinoma in 17 (22%), mixed in four (5%) and undifferentiated carcinoma in five (6%). Three patients were completely incontinent day and night. Stress urinary incontinence after this surgery was reported in 11 (14%) patients, with daytime continence reported in 64 (82%); 59 (76%) patients were completely continent day and night. Chronic retention developed in nine (12%) patients. There was pouch prolapse through the vaginal stump in five (6%) patients, and a pouch-vaginal fistula in seven (9%). Sexual dysfunction was reported in 45 (69%) patients of 65 sexually active women. Stones formed in the pouch in five (6%) patients, while there were renal stones in four renal units. Oncological recurrence was reported in 15 (19%) patients, which was local in 11 (14%) and distant in four (5%).
  
  
  CONCLUSIONS
  The long-term results showed that orthotopic neobladder construction after RC in women provides oncological safety and is functionally effective with proper surgical technique. Removal of the gynaecological organs during RC in women might be unnecessary for low-grade, low-stage tumour.
authors.affiliation: Department of Urology, Faculty of Medicine, Sohag University, Egypt.
authors.forename: Abdelbasset A
authors.initials: AA
authors.lastname: Badawy
authors.affiliation: Department of Urology, Qena University Hospital, South Valley University, Qena, Egypt.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Abolyosr
authors.affiliation: Department of Urology, Faculty of Medicine, Sohag University, Egypt.
authors.forename: Elnisr R
authors.initials: ER
authors.lastname: Mohamed
authors.affiliation: Department of Urology, Faculty of Medicine, Sohag University, Egypt.
authors.forename: Abdelmoneim M
authors.initials: AM
authors.lastname: Abuzeid
keywords: CIC, clean intermittent catheterization; Female; Ileal neobladder; Orthotopic diversion; Outcome; RC, radical cystectomy; US, ultrasonography