Clinical application and long-term follow-up of the substitution of a segmental sinus-body of stomach for urinary bladder / 中华泌尿外科杂志

ABSTRACT

Objective To evaluate the reconstruction of bladder using a segmental sinus-body of stomach on the basis of a clinical study.Methods We retrospectively reviewed the medical records,laboratory evaluations,imaging examinations,cystoscopy,urodynamic studies of 30 patients(17 men and 13 women;mean age,55 years;age range,21-69 years) who underwent the reconstruction of bladder using a segmental sinus-body of stomach.Of the 30 patients,24 had primary bladder cancer and 6 had tuberculous contracture of the bladder.Results After operation,the new gastric bladder worked well in keeping and emptying urine.All patients micturated through the urethra.The bladder capacity was 280-580 ml(mean,385 ml).The maximum urethral pressure was 20-60 cm H_2O(mean,49 cm H_2O).The filling bladder pressure was 5-15 cm H_2O(mean,12 cm H_2O).The maximum bladder pressure was 35-65 cm H_2O(mean,55 cm H_2O),and it was 28-60 cm H_2O(mean,46 cm H_2O) during urination.Qmax and post-void residual urine were 10-28 ml/s(mean,18 ml/s) and 5-85 ml(mean,20 ml),respectively.Follow-up ranged from 9 months to 24 years(mean,8.2 years).There were no disturbance of water and electrolyte metabolism,no vesicoureteral reflux,no uracratia,and no damage to renal function.Complications included perineal and vesical pain in 4 cases,enuresis in 5 cases,which gradually remitted 3-6 months after surgery,and bladder stone formation in 1 case,who underwent surgery again.At 3.5 years after surgery bladder tumor relapsed in 1 case,who then underwent transurethral resection of bladder tumor. Conclusions Our data show that the substitution of a segmental sinus-body of stomach for urinary bladder worth popularizing because of low complication rate and approximately normal urologic indexes.