Premium
Sigmoid orthotopic neobladder after radical cystectomy for bladder tumour: an Indian experience
Author(s) -
Yadav Sher Singh,
Sadadukhi Trilok Chand,
Sharma Krishnan Kumar,
Yadav Ram Gopal,
Mathur Rajeev
Publication year - 2007
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2006.06541.x
Subject(s) - cystectomy , medicine , urinary diversion , urology , sigmoid colon , surgery , bladder cancer , anastomosis , transitional cell carcinoma , urinary system , urinary bladder , rectum , cancer
Authors from India describe their experience using a sigmoid orthotopic neobladder in patients who have had a radical cystectomy. They found a fairly high complication rate, with nocturnal incontinence occurring in 97% of their patients. Other complications were relatively few, and the authors felt that their sigmoid neobladder presented a valuable option for diverting urine after radical cystectomy. OBJECTIVE To determine the long‐term results of constructing a sigmoid neobladder after radical cystectomy for transitional cell carcinoma (TCC) of the urinary bladder. PATIENTS AND METHODS The study included 170 patients with TCC of the bladder and a normal sigmoid colon. After radical cystectomy the neobladder was formed by completely detubularizing an isolated sigmoid colon segment. Subsequently patients were followed by clinical, biochemical, radiological and urodynamic assessments. RESULTS Four patients died soon after surgery; the neobladder‐related delayed complications were death in three patients, loss of five renal units, and electrolyte imbalance in five patients. Uretero‐intestinal anastomotic narrowing was another frequent delayed complication. Most (97%) patients had nocturnal incontinence, and most voided with a good stream with a minimal postvoid residual urine volume. CONCLUSION The sigmoid neobladder, despite some limitations, is the best option for diverting urine after radical cystectomy.