Short‐Term Functional and Urodynamic Outcome of W‐ileal Orthotopic Neobladder with Serosa‐Lined Tunneled Uretero‐Ileal Anastomosis. Issue 1 (12th March 2013)

• Record Type: Journal Article
• Authors: BARAPATRE, Yogesh R.; AGARWAL, Mayank M.; MAVUDURU, Ravimohan; SHARMA, Suresh K.; KUMAR, Santosh; SINGH, Shrawan K.; MANDAL, Arup K.
• Is Part Of: LUTS. Volume 6:Issue 1(2014)
• Page Start: 26
• Page End: 34
• Publication Date: 2013-03-12
• Subjects: Urology -- Periodicals; Urologic Diseases -- Periodicals; Urinary Tract Physiological Phenomena -- Periodicals; 616.62
• DOI: 10.1111/luts.12014
• Languages: English
• ISSNs: 1757-5664

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="luts12014-sec-0001" sec-type="section"> <title>Objectives</title> <p>Functional and urodynamic (UDS) outcomes of W‐configured ileal orthotopic neobladder (ONB) with extramural serosa‐lined tunnel uretero‐ileal anastomosis are presented</p> </sec> <sec id="luts12014-sec-0002" sec-type="section"> <title>Methods</title> <p>Consecutive 17 patients undergoing ONB during December 2009 to March 2011 were enrolled. Of these 15 men (bladder cancer 14, tuberculosis 1) with mean age 52.7 ± 11.3 years completed the follow‐up. Pouch‐related quality of life (PQOL) was assessed using a published questionnaire. Uroflowmetry, cystometry/cystography and urethral‐pressure profilometry were done at two follow‐up visits at least 3 months apart. Mean follow up 10 ± 5 months. Mean length of harvested ileum 48 ± 6 cm.</p> </sec> <sec id="luts12014-sec-0003" sec-type="section"> <title>Results</title> <p>Overall PQOL were similar at both evaluations (55 ± 11 and 54 ± 15, respectively). During first and second follow‐up, maximum flow‐rate, voided‐volume and post‐void residual urine were 11 ± 4 mL/sec, 246 ± 99 mL and 68 ± 74.9 mL and 10.4 ± 4.6 mL/sec, 234 ± 138 mL and 86 ± 146 mL, respectively. Mean neobladder capacity, compliance, maximum urethral closure‐pressure (MUCP) and functional urethral length were 484 ± 244 mL, 50.5 ± 49.1 mL/cmH<sub>2</sub>O, 42 ±20 cmH<sub>2</sub>O and 22 ± 12 mm, and 468 ± 250 mL, 46.4 ± 47.5 mL/cmH<sub>2</sub>O, 52 ± 27cmH<sub>2</sub>O and 23 ± 12 mm, respectively. Patients with smaller pouch (r = 0.828; <italic>P</italic> = 0.0001), longer urethral length (r = −0.392; <italic>P</italic> = 0.023) and lesser incontinence (r = 0.429; <italic>P</italic> = 0.011) had significantly better PQOL. With continued supervised pelvic‐floor rehabilitation, a trend in improvement in hesitancy (<italic>P</italic> = 0.058), MUCP (<italic>P</italic> = 0.05) and bothersome incontinence (<italic>P</italic> = NS) was observed. None of the patients had any obstruction or reflux of the upper tracts.</p> </sec> <sec id="luts12014-sec-0004" sec-type="section"> <title>Conclusion</title> <p>The index ONB has reasonable storage and voiding characteristics but with a rider of nocturnal urinary incontinence.</p> </sec> </abstract>