New Technique of Orthotopic Ileal Neobladder: Early Experience / 대한비뇨기과학회지

ABSTRACT

PURPOSE: During the last 10 years, a multitude of different ileal neobladders have been reported. The ureterointestinal anastomotic site stricture has been shown to be one of the most common late complications. To avoid the stricture, a new orthotopic ileal neobladder was constructed, with two chimneys and two afferent ileal limbs beside the reservoir. MATERIALS AND METHODS: Twenty-six men, with invasive bladder cancer, underwent a radical cystectomy, with the creation of a two chimney ileal neobladder. The mean follow-up was 18 months. The complications were assessed and divided into those related or unrelated to the urinary tract. The continence was evaluated using patient questionnaires. RESULTS: There was no case of an ureteroileal anastomotic site stricture. Five cases of vesicoureteral reflux were noted in the 52 ureteral units. Good, or satisfactory, day- and nighttime urinary continence was reported at the 6 month follow-up by 92.3 and 69.2% of patients, respectively. CONCLUSIONS: The ileal neobladder with two chimneys would be an appropriate technique for the reduction of the ureteroileal anastomotic stricture rate and to overcome some of limitations of the ureteral length.