ABSTRACT
Objective: To report on the complications following orthotopic ileal W-neobladder with serous lined extramural antireflux ureteral implantation. Patients and Methods The records of 520 patients that had undergone one-stage radical cystectomy and orthotopic ileal neobladder were reviewed retrospectively including the follow-up files. Special attention was directed towards the mortality; morbidity and late complications recorded during the follow-up evaluation. Results Hospital mortality was reported in 5 cases. Eighty-one early complications were observed in 60 patients (11.5); including GIT complications in 13; wound infection in 22 and pouchovaginal fistulae in 3. Out of 520 patients 400 were evaluable (308 men and 92 women). Tumor recurrence was documented in 101 patients (20) including 5 with isolated urethral recurrence (0.9). Late complications included pouch stones in 13; outflow obstruction in 12; mucus retention in 4 and adhesive bowel obstruction in 5. Urinary incontinence was found in 9and 18of patients during the day and night times; respectively. Hypercontinence was documented in 9 females. Upper tract deterioration was observed in 36 out of 785 renal units (4.5) due to anastomotic stricture in 32 and chronic pyelonephritis in 4. Poucho-ureteral reflux was seen in 28 units (3.6). Bacteria were isolated in the urine of 32 of 316 examined patients. Serum creatinine was normal in all but 4 patients and 44 patients (11) suffered from subclinical chemical metabolic acidosis. Conclusion The incidence of complications following ileal W-neobladder is low and amenable to treatment in most of the patients. Furthermore; the technique has proved its efficacy and durability