TY - JOUR
T1 - A three-centre experience of orthotopic neobladder reconstruction after radical cystectomy
T2 - Initial results
AU - Meyer, Jon Paul
AU - Drake, Brent
AU - Boorer, James
AU - Gillatt, David
AU - Persad, Rajendra
AU - Fawcett, Derek
PY - 2004/12
Y1 - 2004/12
N2 - OBJECTIVE: To assess, in a retrospective three-centre series, the initial experience and results of patients undergoing radical cystectomy and orthotopic neobladder reconstruction. PATIENTS AND METHODS: The medical records were retrospectively reviewed for 104 suitable consecutive patients undergoing radical cystectomy and orthotopic neobladder reconstruction between June 1994 and April 2003. The initial histology, operating times, transfusion rates, complications, mortality rates, continence rates, potency rates, and cancer control rates were recorded. RESULTS: The median (range) follow-up was 48 (6-113) months; 90 patients had a reconstruction with a 'Studer' neobladder, 12 with a 'Hautmann W pouch' and two with a 'T pouch' ileal neobladder. There were 24 early complications, and in eight patients reoperation was required; there was one death after surgery. There were 14 late complications and 10 patients required reoperation. The daytime continence rate was 99% and the nocturnal continence rate 78%. Five patients required intermittent self-catheterization. Twenty-two patients died from local and/or distant recurrences, and four from other causes. CONCLUSIONS: Orthotopic neobladder reconstruction provides excellent continence rates, and both acceptable complication and mortality rates. Suitable patients undergoing radical cystectomy should be offered orthotopic neobladder reconstruction.
AB - OBJECTIVE: To assess, in a retrospective three-centre series, the initial experience and results of patients undergoing radical cystectomy and orthotopic neobladder reconstruction. PATIENTS AND METHODS: The medical records were retrospectively reviewed for 104 suitable consecutive patients undergoing radical cystectomy and orthotopic neobladder reconstruction between June 1994 and April 2003. The initial histology, operating times, transfusion rates, complications, mortality rates, continence rates, potency rates, and cancer control rates were recorded. RESULTS: The median (range) follow-up was 48 (6-113) months; 90 patients had a reconstruction with a 'Studer' neobladder, 12 with a 'Hautmann W pouch' and two with a 'T pouch' ileal neobladder. There were 24 early complications, and in eight patients reoperation was required; there was one death after surgery. There were 14 late complications and 10 patients required reoperation. The daytime continence rate was 99% and the nocturnal continence rate 78%. Five patients required intermittent self-catheterization. Twenty-two patients died from local and/or distant recurrences, and four from other causes. CONCLUSIONS: Orthotopic neobladder reconstruction provides excellent continence rates, and both acceptable complication and mortality rates. Suitable patients undergoing radical cystectomy should be offered orthotopic neobladder reconstruction.
KW - Continent urinary diversion
KW - Orthotopic neobladder reconstruction
KW - Radical cystectomy
UR - http://www.scopus.com/inward/record.url?scp=11144242238&partnerID=8YFLogxK
U2 - 10.1111/j.1464-410X.2004.05164.x
DO - 10.1111/j.1464-410X.2004.05164.x
M3 - Review article
C2 - 15610113
AN - SCOPUS:11144242238
SN - 1464-4096
VL - 94
SP - 1317
EP - 1321
JO - BJU international
JF - BJU international
IS - 9
ER -