[Imaging follow-up of orthotopic ileal neobladders++]. / Follow-up per immagini nelle neovesciche ileali ortotopiche.

In the follow-up for new urinary reservoirs created from the ileum in the orthotopic position, study by imaging plays a fundamental role The routine radiological examinations for monitoring patients with surgically created orthotopic bladders comprise M.R., C.T., urography, cystography and transrectal ultrasonography (U.S.). By means of these examinations, it is possible to evaluate the ureter-neobladder anastomosis, the capacity of the reservoir and the urethra-neobladder junction. Trans rectal U.S. is of particular importance, providing information on the new neck, the critical point of this new type of urinary diversion. 90 patients with new orthotopic ileal neobladder by Studer were examined. The image investigation in these patients subjected to total cystectomy for cancer, with preparation of a new orthotopic ileal neobladder by Studer, was shown to be indispensable in detecting both of disease and the behaviour of the upper urinary tract following these current urinary diversion.

[Nerve-sparing cystectomy and ileal bladder substitution]. / Cistectomia nerve-sparing e neovescica ileale di sostituzione.

Nerve-sparing techniques and bladder substitution following radical cystectomy allow today to obviate functional sequelae once registered in this type of surgery. Intraoperative identification of the pelvic plexus, which provides autonomic innervation to the corpora cavernosa, is necessary to preserve sexual function. Ileal orthotopic bladder substitution with preservation of the distal urethral sphincter assures a micturition per urethram and the urinary continence. The Authors report their experience with the Studer and Zingg procedure (ileal orthotopic bladder reservoir) performed in 26 cases. Results, technique, complications, and long-term evaluation are stressed.