title: The N-shaped orthotopic ileal neobladder: functional outcomes and complication rates in 119 patients.
abstract: BACKGROUND
  We report our long-term experience with 119 cases of N-shaped orthotopic ileal neobladder.
  
  
  METHODS
  Between March 1996 and July 2013, a total of 119 patients (102 men, 17 women) underwent cystectomy with creation of an N-shaped orthotopic ileal neobladder. The Clavien-Dindo classification score was used for grading early (<3 months postoperative), late, and pouch-related and non-pouch-related complications. Daytime and nighttime continence were evaluated for male and female patients separately, with patients subdivided in three groups: completely continent, use of ≤1 pad, and use of >1 pad.
  
  
  RESULTS
  Median follow-up was 75 months (range 3-204). Early complications (15 major, 54 minor) occurred in 39.5 % of 119 patients whereas 53.1 % presented with late complications (56 major, 39 minor; 111 patients evaluated). Urinary infection and outlet obstruction were both the most frequent early and late pouch-related complications; early non-pouch-related complications were mainly infectious and gastrointestinal, and the most common late non-pouch-related problem was wound herniation. At 12 months, 96 and 60 % of the men and 84.6 and 66.7 % of the women respectively achieved daytime and nighttime continence.
  
  
  CONCLUSIONS
  Complication rates of the N-shaped orthotopic ileal neobladder were relatively high, probably because of meticulous recording and follow-up. Daytime continence rates were better than nighttime rates. N-shaped orthotopic ileal neobladder can be a good option for urinary diversion in selected patients who undergo radical cystectomy.
authors.affiliation: Department of Urology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.
authors.forename: Thomas
authors.initials: T
authors.lastname: De Sutter
authors.affiliation: Department of Urology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium ; Department of Urology, School of Medicine, Selcuk University, Konya, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Akand
authors.affiliation: Department of Urology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.
authors.forename: Maarten
authors.initials: M
authors.lastname: Albersen
authors.affiliation: Department of Urology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.
authors.forename: Wouter
authors.initials: W
authors.lastname: Everaerts
authors.affiliation: Department of Urology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.
authors.forename: Ben
authors.initials: B
authors.lastname: Van Cleynenbreugel
authors.affiliation: Department of Urology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: De Ridder
authors.affiliation: Department of Urology, Ziekenhuis Oost-Limburg, Genk, Belgium.
authors.forename: Hans
authors.initials: H
authors.lastname: Goethuys
authors.affiliation: Department of Urology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.
authors.forename: Lisa
authors.initials: L
authors.lastname: Moris
authors.affiliation: Department of Urology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.
authors.forename: Uros
authors.initials: U
authors.lastname: Milenkovic
authors.affiliation: Department of Urology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.
authors.forename: Hendrik
authors.initials: H
authors.lastname: Van Poppel
authors.affiliation: Department of Urology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.
authors.forename: Frank
authors.initials: F
authors.lastname: Van Der Aa
authors.affiliation: Department of Urology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.
authors.forename: Steven
authors.initials: S
authors.lastname: Joniau
keywords: Bladder substitution; Complications; Continence; Cystectomy; Ileal orthotopic neobladder