Continence after total bladder replacement: urodynamic analysis of the ileal neobladder
| Autor: | Richard E. Hautmann, K. Miller, D. Frohneberg, R. Bachor, G. Egghart |
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| Rok vydání: | 1990 |
| Předmět: |
Male
medicine.medical_specialty Urology media_common.quotation_subject medicine.medical_treatment Bladder capacity Urinary Diversion Cystectomy Urination Asymptomatic Postoperative Complications Ileum medicine Pressure Humans Bladder substitution media_common Urinary bladder business.industry Urethral sphincter Surgery Urodynamics medicine.anatomical_structure Urinary Incontinence Bladder replacement medicine.symptom business |
| Zdroj: | British journal of urology. 65(5) |
| ISSN: | 0007-1331 |
| Popis: | Since April 1986 we have carried out 103 bladder substitutions with the ileal neobladder; 91 of these were performed after radical cystectomy in males (group 1) and 12 after subtotal bladder resection (group 2); 55 patients in group 1 and 8 in group 2 were followed up by long-term urodynamic investigations and by a questionnaire concerning micturition patterns and continence at home 3 months post-operatively. The maximum bladder capacity was approximately 770 ml with an absolute intravesical pressure of 23 to 30 cm H2O. Intravesical pressure waves with a mean amplitude of 20 cm H2O were found in 38% of patients in group 1 and 25% in group 2; 61% of these patients were asymptomatic. The results showed that 85% of patients were continent by day and by night. We attribute this to our operative technique: the ileal loop is folded 4 times in a "W" or "M" shape to achieve complete detubularisation of the bowel and the external urethral sphincter is carefully preserved. Altogether, these data show the ileal neobladder technique to be a reliable and safe method of bladder substitution. |
| Databáze: | OpenAIRE |
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