Twenty Years Experience With an Ileal Orthotopic Low Pressure Bladder Substitute—Lessons to be Learned

医学 泌尿科 普通外科
作者
Urs E. Studer,Fiona C. Burkhard,Martin Schumacher,Thomas M. Kessler,Harriet C. Thoeny,Achim Fleischmann,George N. Thalmann
出处
期刊:The Journal of Urology [Ovid Technologies (Wolters Kluwer)]
卷期号:176 (1): 161-166 被引量:369
标识
DOI:10.1016/s0022-5347(06)00573-8
摘要

No AccessJournal of UrologyAdult urology1 Jul 2006Twenty Years Experience With an Ileal Orthotopic Low Pressure Bladder Substitute—Lessons to be Learned Urs E. Studer, Fiona C. Burkhard, Martin Schumacher, Thomas M. Kessler, Harriet Thoeny, Achim Fleischmann, and George N. Thalmann Urs E. StuderUrs E. Studer Department of Urology, University of Bern, Bern, Switzerland More articles by this author , Fiona C. BurkhardFiona C. Burkhard Department of Urology, University of Bern, Bern, Switzerland More articles by this author , Martin SchumacherMartin Schumacher Department of Urology, University of Bern, Bern, Switzerland More articles by this author , Thomas M. KesslerThomas M. Kessler Department of Urology, University of Bern, Bern, Switzerland More articles by this author , Harriet ThoenyHarriet Thoeny Institute of Diagnostic Radiology, University of Bern, Bern, Switzerland More articles by this author , Achim FleischmannAchim Fleischmann Institute of Pathology, University of Bern, Bern, Switzerland More articles by this author , and George N. ThalmannGeorge N. Thalmann Department of Urology, University of Bern, Bern, Switzerland More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(06)00573-8AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We present the long-term results of a large consecutive series of patients undergoing ileal orthotopic bladder substitution following radical cystectomy. Materials and Methods: Between April 1985 and 2005 orthotopic bladder substitution with an ileal low pressure reservoir was performed in 482 patients (including 40 women) after radical and, if possible, nerve sparing cystectomy. In 447 cases the procedure was combined with an afferent ileal isoperistaltic tubular segment. The patients were followed prospectively. Results: In the 482 patients 61 early (less than 30 days) diversion related complications requiring prolonged hospital stay or readmission were noted and 115 late complications required treatment. At 1 year continence was good in 92% of patients during the day and in 79% at night. At last followup 93% of patients could void spontaneously. Of 442 evaluable men 99 (22.4%) reported having erections without and 68 (15.4%) with medical assistance. Ureteroileal stenosis was observed in 12 of 447 (2.7%) patients. Urethral recurrence was detected in 25 of 482 (5%) patients. A total of 15 (5%) patients received vitamin B12 substitution. Renal parenchyma decreased only in patients with preoperative or postoperative ureteral obstruction. After 10 years patients with normal renal function had no long-term acidosis and in 20 patients the incidence of osteoporosis resembled that of the normal population. Conclusions: Ileal orthotopic bladder substitution combined with an afferent ileal tubular segment allows for good long-term functional results provided patients are restrictively selected, postoperative instructions are followed carefully, and typical complications such as outlet obstruction and hernias are treated early. References 1 : L’entéro-cystoplastie après cystoprostatectomie totale pour cancer de vessie. Ann Urol1979; 13: 114. Google Scholar 2 : Cup-patch technique of ileocystoplasty for bladder enlargement or partial substitution. Surg Gynecol Obstet1959; 108: 240. 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Link, Google Scholar © 2006 by American Urological AssociationFiguresReferencesRelatedDetailsCited byReesink D, Gerritsen S, Kelder H, van Melick H and Stijns P (2020) Evaluation of Ureteroenteric Anastomotic Strictures after the Introduction of Robot-Assisted Radical Cystectomy with Intracorporeal Urinary Diversion: Results from a Large Tertiary Referral CenterJournal of Urology, VOL. 205, NO. 4, (1119-1125), Online publication date: 1-Apr-2021.Hautmann R, Volkmer B, Egghart G, Frohneberg D, Gottfried H, Gschwend J, Hefty R, Kleinschmidt K, Küfer R, Miller K, de Petriconi R, Simon J and Wenderoth U (2020) Functional Outcome and Complications following Ileal Neobladder Reconstruction in Male Patients without Tumor Recurrence. More than 35 Years of Experience from a Single CenterJournal of Urology, VOL. 205, NO. 1, (174-182), Online publication date: 1-Jan-2021.Roth B, Furrer M, Giannakis I, Vartolomei M, Boxler S, Wuethrich P, Burkhard F, Thalmann G and Kiss B (2019) Positive Pre-cystectomy Biopsies of the Prostatic Urethra or Bladder Neck Do Not Necessarily Preclude Orthotopic Bladder SubstitutionJournal of Urology, VOL. 201, NO. 5, (909-915), Online publication date: 1-May-2019.Kiss B, Furrer M, Wuethrich P, Burkhard F, Thalmann G and Roth B (2017) Stenting Prior to Cystectomy is an Independent Risk Factor for Upper Urinary Tract RecurrenceJournal of Urology, VOL. 198, NO. 6, (1263-1268), Online publication date: 1-Dec-2017.Ahmed Y, Hussein A, May P, Ahmad B, Ali T, Durrani A, Khan S, Kumar P and Guru K (2017) Natural History, Predictors and Management of Ureteroenteric Strictures after Robot Assisted Radical CystectomyJournal of Urology, VOL. 198, NO. 3, (567-574), Online publication date: 1-Sep-2017.Kretschmer A, Grimm T, Buchner A, Grimm J, Grabbert M, Jokisch F, Schneevoigt B, Apfelbeck M, Schulz G, Bauer R, Stief C and Karl A (2016) Prognostic Features for Objectively Defined Urinary Continence after Radical Cystectomy and Ileal Orthotopic Neobladder in a Contemporary CohortJournal of Urology, VOL. 197, NO. 1, (210-215), Online publication date: 1-Jan-2017.Clifford T, Shah S, Bazargani S, Miranda G, Cai J, Wayne K, Djaladat H, Schuckman A and Daneshmand S (2016) Prospective Evaluation of Continence Following Radical Cystectomy and Orthotopic Urinary Diversion Using a Validated QuestionnaireJournal of Urology, VOL. 196, NO. 6, (1685-1691), Online publication date: 1-Dec-2016.Johnson D and Pruthi R (2016) Urinary Reconstruction after Radical CystectomyJournal of Urology, VOL. 196, NO. 4, (979-980), Online publication date: 1-Oct-2016.Furrer M, Roth B, Kiss B, Nguyen D, Boxler S, Burkhard F, Thalmann G and Studer U (2016) Patients with an Orthotopic Low Pressure Bladder Substitute Enjoy Long-Term Good FunctionJournal of Urology, VOL. 196, NO. 4, (1172-1180), Online publication date: 1-Oct-2016.Hussein A, Hashmi Z, Dibaj S, Altartir T, Fiorica T, Wing J, Durrani M, Binkowski J, Boateng L, Wilding G and Guru K (2015) Reoperations following Robot-Assisted Radical Cystectomy: A Decade of ExperienceJournal of Urology, VOL. 195, NO. 5, (1368-1376), Online publication date: 1-May-2016.Singla N, Montie J, Lee C, Wolf J and Faerber G (2015) Experience with 45 Consecutive Patients with Neobladders Undergoing Retrograde Ureteroscopy for Upper Tract AbnormalitiesUrology Practice, VOL. 2, NO. 5, (244-249), Online publication date: 1-Sep-2015.Xu K, Liu C, Zheng S, Li H, Xu Y, Xu A, Chen B and Shen H (2013) Orthotopic Detaenial Sigmoid Neobladder after Radical Cystectomy: Technical Considerations, Complications and Functional OutcomesJournal of Urology, VOL. 190, NO. 3, (928-934), Online publication date: 1-Sep-2013.Large M, Cohn J, Kiriluk K, Dangle P, Richards K, Smith N and Steinberg G (2013) The Impact of Running versus Interrupted Anastomosis on Ureterointestinal Stricture Rate after Radical CystectomyJournal of Urology, VOL. 190, NO. 3, (923-927), Online publication date: 1-Sep-2013.Schöndorf D, Meierhans-Ruf S, Kiss B, Giannarini G, Thalmann G, Studer U and Roth B (2013) Ureteroileal Strictures After Urinary Diversion with an Ileal Segment—Is There a Place for Endourological Treatment at All?Journal of Urology, VOL. 190, NO. 2, (585-590), Online publication date: 1-Aug-2013.Ahmadi H, Skinner E, Simma-Chiang V, Miranda G, Cai J, Penson D and Daneshmand S (2012) Urinary Functional Outcome Following Radical Cystoprostatectomy and Ileal Neobladder Reconstruction in Male PatientsJournal of Urology, VOL. 189, NO. 5, (1782-1788), Online publication date: 1-May-2013.Anderson C, Morgan T, Kappa S, Moore D, Clark P, Davis R, Penson D, Barocas D, Smith J, Cookson M and Chang S (2012) Ureteroenteric Anastomotic Strictures After Radical Cystectomy—Does Operative Approach Matter?Journal of Urology, VOL. 189, NO. 2, (541-547), Online publication date: 1-Feb-2013.Song C, Kim S, Park J, Moon D and Ahn H (2011) Renal Function Change After Refluxing Type Orthotopic Ileal SubstitutionJournal of Urology, VOL. 186, NO. 5, (1948-1952), Online publication date: 1-Nov-2011.Shimko M, Tollefson M, Umbreit E, Farmer S, Blute M and Frank I (2010) Long-Term Complications of Conduit Urinary DiversionJournal of Urology, VOL. 185, NO. 2, (562-567), Online publication date: 1-Feb-2011.Thulin H, Kreicbergs U, Wijkström H, Steineck G and Henningsohn L (2010) Sleep Disturbances Decrease Self-Assessed Quality of Life in Individuals Who Have Undergone CystectomyJournal of Urology, VOL. 184, NO. 1, (198-202), Online publication date: 1-Jul-2010.Ong C, Schmitt M, Thalmann G and Studer U (2010) Individualized Seminal Vesicle Sparing Cystoprostatectomy Combined With Ileal Orthotopic Bladder Substitution Achieves Good Functional ResultsJournal of Urology, VOL. 183, NO. 4, (1337-1342), Online publication date: 1-Apr-2010.Lowrance W, Rumohr J, Clark P, Chang S, Smith J and Cookson M (2009) Urinary Diversion Trends at a High Volume, Single American Tertiary Care CenterJournal of Urology, VOL. 182, NO. 5, (2369-2375), Online publication date: 1-Nov-2009.Novara G, De Marco V, Aragona M, Boscolo-Berto R, Cavalleri S, Artibani W and Ficarra V (2009) Complications and Mortality After Radical Cystectomy for Bladder Transitional Cell CancerJournal of Urology, VOL. 182, NO. 3, (914-921), Online publication date: 1-Sep-2009.Zehnder P, Dhar N, Thurairaja R, Ochsner K and Studer U (2009) Effect of Urinary Tract Infection on Reservoir Function in Patients With Ileal Bladder SubstituteJournal of Urology, VOL. 181, NO. 6, (2545-2549), Online publication date: 1-Jun-2009.Msezane L, Reynolds W, Mhapsekar R, Gerber G and Steinberg G (2008) Open Surgical Repair of Ureteral Strictures and Fistulas Following Radical Cystectomy and Urinary DiversionJournal of Urology, VOL. 179, NO. 4, (1428-1431), Online publication date: 1-Apr-2008.Schumacher M, Scholz M, Weise E, Fleischmann A, Thalmann G and Studer U (2018) Is There an Indication for Frozen Section Examination of the Ureteral Margins During Cystectomy for Transitional Cell Carcinoma of the Bladder?Journal of Urology, VOL. 176, NO. 6, (2409-2413), Online publication date: 1-Dec-2006. Volume 176Issue 1July 2006Page: 161-166 Advertisement Copyright & Permissions© 2006 by American Urological AssociationKeywordscystectomymetabolismbladderfollow-up studiesMetricsAuthor Information Urs E. Studer Department of Urology, University of Bern, Bern, Switzerland More articles by this author Fiona C. Burkhard Department of Urology, University of Bern, Bern, Switzerland More articles by this author Martin Schumacher Department of Urology, University of Bern, Bern, Switzerland More articles by this author Thomas M. Kessler Department of Urology, University of Bern, Bern, Switzerland More articles by this author Harriet Thoeny Institute of Diagnostic Radiology, University of Bern, Bern, Switzerland More articles by this author Achim Fleischmann Institute of Pathology, University of Bern, Bern, Switzerland More articles by this author George N. Thalmann Department of Urology, University of Bern, Bern, Switzerland More articles by this author Expand All Advertisement PDF downloadLoading ...

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