Document Detail


Total and immediate daytime and nighttime continence with a right colonic neobladder--What makes it possible? An 11-year followup.
MedLine Citation:
PMID:  16217329     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: We report the long-term functional results of the colonic neobladder and provide the physiological and urodynamic foundations for them. MATERIALS AND METHODS: From March 1993 to February 2004, 38 patients with cystectomy received a neobladder constructed from detubularized, remodeled right colon and intact cecum following our design at the urology service at our institution. Most patients underwent urodynamics and videourodynamics as postoperative followup. We defined total continence as not using any protection whatsoever (neither pads nor a night alarm), which was immediate upon removing the urethral catheter. RESULTS: A total of 37 patients achieved total daytime continence immediately and the remaining 1 was totally continent after 30 days (100%). Nighttime continence was total and immediate in 36 patients (92%) and satisfactory in 2. Micturition was immediate, satisfactory and total in 37 patients with an average maximum flow of more than 26 ml per second. The patient who did not achieve micturition required clean intermittent catheterization. Videourodynamic studies revealed that continence resulted from the low pressure developed in the large capacity reservoir (more than 600 ml) and from intact intestine haustral contractions, which ejected urine toward the detubularized and remodeled area. In turn, micturition was attained through a combination of abdominal wall tension and mass contractions of the nondetubularized segment, which generated a pressure of more than 100 cm. CONCLUSIONS: The functional results of this new neobladder are significantly greater than those achieved with other procedures already described in the literature because of the different way in which it functions.
Authors:
Osvaldo R D'Orazio; Osvaldo L Lambert; Juan C Vallati; Francisco L Franco; Salomón V Romano; Tomás A de Lasa Stewart; Carlos A Saenz
Related Documents :
9474149 - Correlation between p53 over expression and response to bacillus calmette-guerin therap...
17681969 - Sublingual oxybutynin reduces postoperative pain related to indwelling bladder catheter...
2866119 - Prophylactic phenoxybenzamine in the prevention of postoperative retention of urine aft...
9783969 - Urethral duplication in children: surgical treatment and results.
8178379 - Trial with bacillus calmette-guérin and epirubicin combination in the prophylaxis of s...
16697519 - Effect of intravesical resiniferatoxin (rtx) on lower urinary tract symptoms, urodynami...
1386639 - Augmentation of interleukin-2 production after cardiac operations in patients treated w...
7867819 - Flash and pattern visual evoked potentials in the diagnosis and monitoring of dysthyroi...
21990439 - Clinical predictors of delayed cerebral ischemia after subarachnoid hemorrhage: first e...
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of urology     Volume:  174     ISSN:  0022-5347     ISO Abbreviation:  J. Urol.     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-10-11     Completed Date:  2005-11-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1882-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Urology Division, Hospital Dr. José Penna, Bahía Blanca, Argentina. odorazio@yahoo.com.ar
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Cohort Studies
Colon, Sigmoid / transplantation*
Cystectomy / methods*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Recovery of Function
Retrospective Studies
Risk Assessment
Sensitivity and Specificity
Time Factors
Urinary Bladder Neoplasms / pathology,  surgery*
Urinary Reservoirs, Continent
Urination / physiology*
Urodynamics / physiology
Video Recording

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Long-term urinary continence rates after simple sling incision for relief of urinary retention follo...
Next Document:  The natural history of lower urinary tract dysfunction in men: minimum 10-year urodynamic followup o...