Journal List > Korean J Urol > v.48(1) > 1004830

Nam, Cho, and Lee: Voiding Pattern and Incontinence after Orthotopic Ileal Neobladder in Male Patients

Abstract

Purpose

To report the voiding pattern and continence stati in male patients having undergone a radical cystectomy and orthotopic bladder substitution.

Materials and Methods

Between March 2000 and June 2005, 20 men with advanced bladder cancer had a radical cystoprostatectomy and urinary diversion via an ileal orthotopic bladder substitution. The voiding pattern and continence stati were assessed using patient interviews, frequency-volume charts and pad tests at 1, 3, 6, 9 and 12 months after catheter removal.

Results

The mean age and follow-up were 60.5 years (41-72) and 34.1 months (12-69), respectively. Neobladder substitution was performed with an ileum in all patients. 17 patients had reconstruction with a Studer neobladder and 3 with a W-pouch Hautmann. All patients had transitional cell carcinoma (TCC) and their tumor stages ranged from T1G3 to T4aN1M0. The frequency of voiding ranged from 4 to 12 times during the day, and 0 to 5 times during the night, with a mean maximum neobladder capacity of 336ml (200-620) and maximum flow rate of 24.6ml/sec (12-46) 12 months after removal of the catheter. No patient required intermittent self-catheterization. All-time continence rates were 15, 30, 65 and 85%, and all-time incontinence rates were 55, 25, 10 and 5% at 1, 3, 6 and 9 months after catheter removal, respectively.

Conclusions

Orthotopic bladder substitution has an excellent functional outcome over time, resulting in high daytime and nighttime continence rates within 9 months of catheter removal.

Figures and Tables

Fig. 1
Continence patterns at the time of removal and 3, 6, 9 and 12 months after catheter removal in 20 patients.
kju-48-12-g001
Table 1
Uroflowmetry findings and maximum bladder capacity at the time of removal and 1, 3, 6, 9 and 12 months after the catheter removal in 20 patients
kju-48-12-i001

Data represent mean (range).

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