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Further clinical experience with the ileal W‐neobladder and a serous‐lined extramural tunnel for orthotopic substitution
Author(s) -
ABOLENEIN H.,
GHONEIM M.A.
Publication year - 1995
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1995.tb07778.x
Subject(s) - medicine , serous fluid , cystectomy , bladder cancer , urology , reflux , ileum , surgery , stage (stratigraphy) , cancer , paleontology , disease , biology
Objective To report on the functional results following orthotopic substitution using an ileal W‐neobladder with an extramural serous‐lined tunnel for reflux prevention. Patients and methods Sixty men (mean age 46 years) underwent a one‐stage radical cystoprostatectomy and an ileal W‐neobladder for invasive bladder cancer. The technique entails the creation of two serous‐lined extramural tunnels in a detubularized ileal W‐bladder fashioned from 40 cm of the terminal ileum. Fifty‐one patients were evaluable, with a minimum follow‐up of 2 years. Evaluation of patients included clinical, radiographic and urodynamic studies. Results There was no operative mortality and no gross morbidity. The upper tracts remain unchanged or improved in 97% of the implanted renal units. Reflux was not observed in any patient. The incidence of day and night continence was 90 and 80%, respectively. Conclusion The technique provides a non‐obstructed unidirectional uretero‐ileal re‐implantation, in a low‐pressure system constructed from a short ileal segment. No staples were required.