Orthotopic T pouch ileal neobladder: evaluations of urodynamics and upper urinary tract functions
Niu, Y.-n.; Xing, N.-z.; Zhou, Z.-d.; Chen, Y.-d.; Wang, H.; Zang, T.; Zhang, J.-h.; Wang, J.-w.; Tian, X.-q.; Wu, Z.-j.
Zhonghua Yi Xue Za Zhi 90(44): 3099-3102
2010
ISSN/ISBN: 0376-2491 PMID: 21211336 Document Number: 644401
To evaluate the urodynamics and functions of upper urinary tract in a substitute of orthotopic T pouch ileal bladder. From June 2004 through September 2009, 90 patients underwent the construction of an orthotopic T pouch ileal neobladder after radical cystectomy for muscle-invasive bladder cancer. The radiographic or ultrasound evaluation of upper urinary tract, determination of renal functions and urodynamic evaluation of T pouch ileal neobladder were performed by data analysis. Renal function as determined by serum creatinine remained in a normal range in all patients. Temporary dilation of renal pelvic and ureter was observed in 18 patients (20.0%) at Day 45 post-operation and then disappeared spontaneously in the late follow-up. A slight dilation of collecting system was found in other 4 patients (4.4%), but there was no negative impact on renal function. Reflux into afferent limb of neobladder was observed in 4 patients (4.4%) by cystography. Excellent daytime and nighttime continence was reported in 100% and 82.2% of evaluated patients respectively. The urodynamic assessment showed a mean capacity of (316 ± 96) ml with a mean intra-bladder pressure of (16 ± 10) cm H2O. These evaluated patients voided with a mean maximum intra-bladder pressure of (87 ± 25) cm H2O, a mean maximum flow rate of (17 ± 10) ml/s and a mean residual urine of (33 ± 29) ml. With an intermediate follow-up, the functional results of T pouch ileal neobladder are encouraging with an excellent capacity and compliance, successful daytime and nighttime continence and anti-reflux mechanism.