Short-Term Functional and Urodynamic Outcome of W-ileal Orthotopic Neobladder with Serosa-Lined Tunneled Uretero-Ileal Anastomosis.
Low Urin Tract Symptoms
; 6(1): 26-34, 2014 Jan.
Article
in En
| MEDLINE
| ID: mdl-26663497
ABSTRACT
OBJECTIVES:
Functional and urodynamic (UDS) outcomes of W-configured ileal orthotopic neobladder (ONB) with extramural serosa-lined tunnel uretero-ileal anastomosis are presentedMETHODS:
Consecutive 17 patients undergoing ONB during December 2009 to March 2011 were enrolled. Of these 15 men (bladder cancer 14, tuberculosis 1) with mean age 52.7 ± 11.3 years completed the follow-up. Pouch-related quality of life (PQOL) was assessed using a published questionnaire. Uroflowmetry, cystometry/cystography and urethral-pressure profilometry were done at two follow-up visits at least 3 months apart. Mean follow up 10 ± 5 months. Mean length of harvested ileum 48 ± 6 cm.RESULTS:
Overall PQOL were similar at both evaluations (55 ± 11 and 54 ± 15, respectively). During first and second follow-up, maximum flow-rate, voided-volume and post-void residual urine were 11 ± 4 mL/sec, 246 ± 99 mL and 68 ± 74.9 mL and 10.4 ± 4.6 mL/sec, 234 ± 138 mL and 86 ± 146 mL, respectively. Mean neobladder capacity, compliance, maximum urethral closure-pressure (MUCP) and functional urethral length were 484 ± 244 mL, 50.5 ± 49.1 mL/cmH2 O, 42 ±20 cmH2 O and 22 ± 12 mm, and 468 ± 250 mL, 46.4 ± 47.5 mL/cmH2 O, 52 ± 27cmH2 O and 23 ± 12 mm, respectively. Patients with smaller pouch (r = 0.828; P = 0.0001), longer urethral length (r = -0.392; P = 0.023) and lesser incontinence (r = 0.429; P = 0.011) had significantly better PQOL. With continued supervised pelvic-floor rehabilitation, a trend in improvement in hesitancy (P = 0.058), MUCP (P = 0.05) and bothersome incontinence (P = NS) was observed. None of the patients had any obstruction or reflux of the upper tracts.CONCLUSION:
The index ONB has reasonable storage and voiding characteristics but with a rider of nocturnal urinary incontinence.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Aspects:
Patient_preference
Language:
En
Journal:
Low Urin Tract Symptoms
Year:
2014
Document type:
Article
Affiliation country:
India