| Total and immediate daytime and nighttime continence with a right colonic neobladder--What makes it possible? An 11-year followup. | |
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MedLine Citation:
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PMID: 16217329 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Osvaldo R D'Orazio; Osvaldo L Lambert; Juan C Vallati; Francisco L Franco; Salomón V Romano; Tomás A de Lasa Stewart; Carlos A Saenz |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: The Journal of urology Volume: 174 ISSN: 0022-5347 ISO Abbreviation: J. Urol. Publication Date: 2005 Nov |
Date Detail:
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Created Date: 2005-10-11 Completed Date: 2005-11-15 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0376374 Medline TA: J Urol Country: United States |
Other Details:
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Languages: eng Pagination: 1882-6 Citation Subset: AIM; IM |
Affiliation:
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Department of Surgery, Urology Division, Hospital Dr. José Penna, Bahía Blanca, Argentina. odorazio@yahoo.com.ar |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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
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