Orthotopic neobladder: A 22-year experience

Abstract

Objective: To analyze the outcome of orthotopic ileal neobladder related to complications and quality of life. Patients and methods: From 1985 to 2006, 75 patients with mean age of 57 years, (41-75) underwent radical cystectomy and orthotopic ileal neobladder substitution. The mean follow up was 72 months (6-144). Mean operative time was 240 minutes. Results: Intraoperative blood loss ranged from 250 to 2810 ml. Ureteral stents were removed on 14th postoperative day, and patients were discharged at 21st day, average. Complications appeared in 23 patients. There were two recurrent TCC in the neobladder. Three patients died from pulmonary embolism. Vesicoureteral reflux appeared in three patients, and it was bilateral in two patients. Total of 98% patients have daytime continence. Conclusion: Continent urinary reservoirs represent the state of the art in urinary diversion. Surgeons who perform these operations are urgent to institute requirements for careful long-term follow-up of these patients.