Modified le bag pouch after radical cystectomy : continence, urodynamic results and morbidity
Author
Source
Journal of the Egyptian National Cancer Institute
Issue
Vol. 22, Issue 1 (31 Mar. 2010), pp.29-39, 11 p.
Publisher
Cairo University National Cancer Institute
Publication Date
2010-03-31
Country of Publication
Egypt
No. of Pages
11
Main Subjects
Topics
Abstract EN
Objectives : to reevaluate ileocolonic pouch for orthotropic neobladder reconstruction, a cohort of patients with bladder cancer was selected to undergo radical cystectomy and modified Le Bag pouch.
Evaluation concentrates on continence and associated morbidity observed on close follow-up.
Patients and Methods : A total of 37 patients including 16 females with T2-3 bladder cancer (19 transitional, 15 squamous and 3 adenocarcinoma) were treated by radical cystectomy and totally detubularized ileocolic neobladder.
Post-operative morbidity, continence and urodynamic studies were evaluated.
Mean time to have full daytime continence was tested against age, gender, postoperative complications, technique of pouch creation either stapler or hand suture and adjuvant irradiation.
Results : Customary 12 months post-surgery showed 493 ml median capacity with basal and maximum reservoir median pressures of 16 and 38cmH2O respectively.
Uroflowmetry had maximum voiding volume of 370ml, voiding time 45s and maximum flow rate of 11.6ml / s.
Within the first 2 months post-operative 44 % were continent by day, 33 % by night and 67 % had stress incontinence.
By 12 months post-surgery 89 % were continent by day, 73 % by night and 27 % had stress incontinence.
Two years post-surgery 94 % were continent by day and 81 % had complete day and night control of urine.
Urinary leakage was the most frequent early complication (10.8 %).
Late complications were urinary tract infection (13.5 %), metabolic acidosis (13.5 %) and reflux (10.8 %).
Pouch over distension (5.4 %) was consistent with bladder neck obstruction.
Patient’s gender and postoperative morbidity were statistically significant factors to increase the mean time to continence; whereas, age, use of stapler and adjuvant radiotherapy had no significant effect Conclusion : Modified Le Bag pouch is a simple technique with adequate pouch capacity that offers excellent slowly progressing continence rates with minor morbidity rate.
Post-operative morbidity and female sex delayed continence satisfaction.
American Psychological Association (APA)
Nassar, Umayyah Abd al-Hamid. 2010. Modified le bag pouch after radical cystectomy : continence, urodynamic results and morbidity. Journal of the Egyptian National Cancer Institute،Vol. 22, no. 1, pp.29-39.
https://search.emarefa.net/detail/BIM-273852
Modern Language Association (MLA)
Nassar, Umayyah Abd al-Hamid. Modified le bag pouch after radical cystectomy : continence, urodynamic results and morbidity. Journal of the Egyptian National Cancer Institute Vol. 22, no. 1 (Mar. 2010), pp.29-39.
https://search.emarefa.net/detail/BIM-273852
American Medical Association (AMA)
Nassar, Umayyah Abd al-Hamid. Modified le bag pouch after radical cystectomy : continence, urodynamic results and morbidity. Journal of the Egyptian National Cancer Institute. 2010. Vol. 22, no. 1, pp.29-39.
https://search.emarefa.net/detail/BIM-273852
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references : p. 38-39
Record ID
BIM-273852