Functional and metabolic results of 24 Bordeaux-type bladder replacements following total prostato-cystectomy with a more than 2 years follow-up
Le Guillou, M.; Pariente, J.L.; Mettetal, P.; Bouker, A.; Gueye, S.M.; Ferriere, J.M.
Acta Urologica Belgica 59(4): 127-131
1991
ISSN/ISBN: 0001-7183 PMID: 1819199 Document Number: 376134
In March 1985, we realised the first Bordeaux neo-bladder, with detubularized ileo-colic segment (15 cm of ascending colon and 20 to 25 cm of ileum). The urethra is anastomosed at the lowest point of the caecum. 61 male patients underwent total replacement of the bladder, and we analyse the results in 24 of them, with a follow up more than 2 years. The following results were noted: the sensation of voiding is always physiological, daytime continence is quite perfect, while nighttime continence is good for 71% of patients, the filling pressure of the neobladder is low with a maximum of 20 cm H 0 (range 5-20 cm H20), and its capacity ranged from 300 ml to 400 ml, the mean flow rate is 21 ml/s. We encountered no complication, nothing but 2 gall-stones and two patients with low vitamin B 12. We didn't note neither diarrhea, nor hyperchloremic acidosis. All patients maintained normal renal function. Initially, the indication of Bordeaux ileo-colic neobladder was limited to bladder replacement after cysto-prostatectomy for bladder cancer. Now, the good results obtained, and their durability without any major complication allow us to extend our indications to bladder enlargements in neurogenic bladders.