Long-term functional outcome and late complications of Studer's ileal neobladder.

OBJECTIVE The purpose of this study was to evaluate the long-term functional outcome and late complications of Studer's ileal neobladder. METHODS The study included 57 patients who underwent radical cystectomy and bladder reconstruction with Studer's ileal neobladder, and were followed-up for at least 3 months after surgery. The voiding and storage function, and late complications were evaluated. The times of evaluation after surgery were categorized into periods I (3-23 months), II (24-59 months), III (60-95 months) and IV (> or =96 months). RESULTS Daytime and night-time continence rates were 95.6 and 88.6%, respectively. The averages of functional capacity (439 ml), maximum flow rate (15.7 ml/s) and residual urine (35 ml) evaluated in period I were maintained in period IV. Of the 57 patients, intermittent self-catheterization was needed in five (8.8%) due to incomplete emptying or urinary retention. Urethroileal anastomotic stricture was found in two patients (3.5%), who were successfully treated by transurethral intervention. Inguinal hernia was found in seven patients (12.8%), five of whom developed it within 2 years after surgery. CONCLUSIONS Our results indicate that Studer's ileal neobladder had a favorable long-term functional outcome. Although late complication rates were low, the incidence of inguinal hernia was relatively high, and this was considered as a definite late complication in our study.

[1]  L. Ronningen Campbell's Urology, 8th ed , 2005 .

[2]  T. Kessler,et al.  Ileal orthotopic bladder substitute combined with an afferent tubular segment: long-term upper urinary tract changes and voiding pattern. , 2004, European urology.

[3]  U. Studer,et al.  Managing patients after an ileal orthotopic bladder substitution , 2004, BJU international.

[4]  K. Yoshimura,et al.  High incidence of inguinal hernia after radical retropubic prostatectomy. , 2004, Urology.

[5]  H. Danuser,et al.  Summary of 10 years' experience with an ileal low-pressure bladder substitute combined with an afferent tubular isoperistaltic segment , 2004, World Journal of Urology.

[6]  K. Shigeno,et al.  Postoperative morbidity, functional results and quality of life of patients following orthotopic neobladder reconstruction , 2003, International journal of urology : official journal of the Japanese Urological Association.

[7]  F. Burkhard,et al.  Long-term voiding pattern of patients with ileal orthotopic bladder substitutes. , 2002, The Journal of urology.

[8]  F. Burkhard,et al.  Bladder Substitution in Women , 2000, International Urogynecology Journal.

[9]  M. Blute,et al.  Comparison of studer ileal neobladder and ileal conduit urinary diversion with respect to perioperative outcome and late complications. , 1998, The Journal of urology.

[10]  T. Tsukamoto,et al.  Ileal Neobladder for Bladder Substitution after Radical Cystectomy , 1998, International journal of urology : official journal of the Japanese Urological Association.

[11]  U. Studer,et al.  Ileal orthotopic bladder substitutes. What we have learned from 12 years' experience with 200 patients. , 1997, The Urologic clinics of North America.

[12]  T. Hirose,et al.  Voiding dysfunction in ileal neobladder. , 1997, The Journal of urology.

[13]  M. Benson,et al.  The ileal ureter neobladder is associated with a high success and a low complication rate. , 1997, The Journal of urology.

[14]  P. De Carli,et al.  Lower urinary tract reconstruction following cystectomy: experience and results in 96 patients using the orthotopic ileal bladder substitution of Studer et al. , 1996, European urology.

[15]  D. Skinner,et al.  Orthotopic urinary diversion. , 1995, Contemporary urology.