The Impact of preservation of the prostatic apex on the urodynamic characteristics in different orthotopic ileal reservoirs
Afr. j. urol. (Online)
;
8(4): 197-206, 2003.
Article
in English
| AIM
| ID: biblio-1258164
ABSTRACT
Objective This study was carried out to evaluate the urodynamic characteristics of the Camey II; Kock's and W-configured ileal reservoirs utilized for orthotopic urinary diversion. Patients and Methods Between January 2000 and 2002; 42 male patients prospectively underwent radical cystoprostatectomy for bladder cancer followed by orthotopic urinary diversion at the urology department of Cairo University hospitals. All cases were evaluated clinically; bacteriologically; radiologically and urodynamically including uroflowmetry; medium-fill and voiding enterocystometry and urethral pressure profilometry; which was done in the early and late postoperative period (at 3-6 months and 6-18 months). Patients were divided into four groups Group I 11 cases with preservation of the prostatic apex and creation of a W-neobladder. Group II 11 cases without prostatic apex preservation and creation of a W-shaped ileal pouch. Group III 12 cases without prostatic apex preservation and creation of a Camey II pouch. Group IV 8 cases without prostatic apex preservation and creation of a Kock's pouch. Results The patients of Group I had a larger mean neobladder capacity (699 ml) and volume at which the first contraction occurred (315 ml) and a larger amount of residual urine (224 ml) as compared to Group II (511.1; 285 and 77.5 ml; respectively); Group III (375; 200 and 55 ml; respectively) and Group IV (563; 266 and 600 ml; respectively). Also Group I with a preserved prostatic apex had a higher mean intraluminal opening pressure (55 cm H2O) and a higher pressure at maximum flow (62.36 cm H20) as compared to the patients with complete prostatic resection. Conclusion We conclude that the patients with a preserved prostatic apex (Group I) had a statistically significant higher mean residual urine in the early and late postoperative period and a significantly higher mean maximum cystometric capacity in the late postoperative period as compared to those recorded in patients with complete prostatic resection (Groups II; III; IV). A higher incidence of upper tract deterioration was detected in Group I (35) vs. 4.6; 27.8and 12.5in Groups II; III and IV; respectively
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Index:
AIM (Africa)
Main subject:
Urinary Diversion
/
Urodynamics
/
Urinary Bladder
/
Cystectomy
/
Ileum
Language:
English
Journal:
Afr. j. urol. (Online)
Year:
2003
Type:
Article
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