Long-term results of standard procedures in urology: the ileal neobladder

摘要: Over the past 20 years orthotopic urinary reconstruction with techniques developed at Ulm and Bern has become a widely accepted form of diversion. So far, both centers together have performed more than 1,300 bladder substitutions an overall rate neobladder formation in 58% all cystectomized patients. Today, absolute contraindications for this procedure are stress incontinence, damaged rhabdosphincter, severely impaired renal liver function, severe intestinal diseases or oncologic situation requiring urethrectomy. In patients treated transitional cell carcinoma bladder, urethral recurrence was 1.5 5%, respectively, upper tract 2-3%. Local tumor usually did not affect function. The outlet obstruction by local 2%, that gross hematuria 1%, entero-reservoir fistulas 1-2%. Daytime continence 12 months 92%, while nighttime lower around 80%. Transient permanent retention seen 11-12% male series, long-term safety good. risk stenoses uretero-intestinal anastomosis consecutive loss function decreased introduction non-refluxing implantation techniques. metabolic complications remains low when adequate substitution sodium bicarbonate is guaranteed Patient selection meticulous postoperative follow-up contributed to achieve good results after cystectomy ileal two large series from Universities Bern.