Long-term outcome of female orthotopic ileal neobladder / 中华泌尿外科杂志

Objective To evaluate the clinical application of female orthotopic ileal neobladder.Methods Modified radical cysteetomy plus orthotopic ileal neobladder was performed on 19 female pa-tients with bladder cancer from June 1999 to January 2008.The mean age of the patients was 52(45-66) years,mean course of disease was 4.4 months (16 days-1.9 years).Of all the patients,there were 10 cases with grade 1,7 cases with grade 2 and 2 cases grade 3.According to the UICC stage system,5 patients were T1 stage,12 T2 and 2 T3a.All the patients received modified radical cystecto-my without resection of uterus and anterior vagina,meanwhile the nerves around urethra were protec-ted.0.8-1.2 cm proximal end of the urethra was excised and 30 cm distal ileum was used for the re-construction of the neobladder.Results Sixteen cases were followed up for 6-102 months,mean 71 months.Fifteen patients survived without disease recurrence,1 patient died of myocardial infarc-tion 17 months postoperation.The daytime and night continent rate was 100$,93% at 9 months postoperative.The average voiding volume of the 15 patients was 519.0 ml.The average residual vol-ume was 29.2 ml,and Qmax was 18.6 ml/s.The average filling and voiding pressure was 16.7 cm H2O and 53.0 cm H2O.Intravenous urography showed slight hydronephrosis in 1 case.Conclusion Female orthotopic ileal neobladder could be a good choice because of the continence,fewer complica-tions,lower pressure and enough bladder capacity.

A Case of Congenital Megalourethra / 대한비뇨기과학회지

Megalourethra is a rare congenital abnormaly characterized by severe dilatation of urethra, the disorder at first reported by Nesbitt in 1955. The scaphoid type is due to poor development of the corpus spongiosum, whereas in the more severe fusiform variety the corpora cavernosa also are affected. We present a case of congenital scaphoid megalourethra associated with acute renal failure, sepsis and grade IV bilateral vesicoureteral reflux. Initial management of this patient was vesicocutaneostomy and urethrocutaneostomy followed later by urethral reconstruction.