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Detublarized sigmoid colon for total urinary bladder replacement : clinical outcome in 51 patients
Joint Authors
Badawi, Ashraf
Muhammad, Abd al-Rahman
Basyuni, Mahmud
al-Shirbini, Majdi
Murad, Ismail A.
Source
Journal of the Egyptian National Cancer Institute
Issue
Vol. 15, Issue 3 (30 Sep. 2003), pp.201-208, 8 p.
Publisher
Cairo University National Cancer Institute
Publication Date
2003-09-30
Country of Publication
Egypt
No. of Pages
8
Main Subjects
Topics
Abstract EN
Objectives : the technique and results of a detublarized sigmoid neobladder for total urinary bladder substitution after radical cystectomy is described.
Methods : Fifty one patients (44 men and 7 women) having a mean age of 46 (range, 32-61 years).
Radical cyst prostatectomy was performed for the male patients and anterior pelvic exoneration for the female patients.
This was followed by total replacement of the bladder with a detubularized sigmoid colon.
They were selected to have invasive bladder cancer away from the bladder neck.
The mean follow-up period was 38.8 months (range 8-96).
Blood chemistry was analyzed periodically every month during the follow-up period.
Early and late complications, continence and voiding pattern were recorded.
Urodynamic studies were performed every 6 months.
Results : Early postoperative complications included, urinary leakage in 7 patients (14 %) ; wound infection in 11 patients (22 %), deep venous thrombosis of the lower extremities in one patient (2 %).
Late complications included stenosis of the ureter intestinal anastomosis in one patient (2 %), stenosis of urethral anastomosis in one patient (2 %).
A reservoir stone occurred in one patient (2 %).
Neither metabolic acidosis nor vitamin B12 deficiency was reported.
The upper urinary tract function was either improved or stable in 96 % of cases.
However, deterioration occurred in only 4% of cases.
All patients could void voluntary without catheterization.
Patient satisfaction for continence, by daytime and nighttime (nocturnal continence), was 86 % and 72 %, respectively.
The mean neo-bladder capacity and mean residual urine volume was 463.8 ml (range, 275-603) and 93.7 ml (range 50-189), respectively.
Pressure flow analysis showed that the mean basal pressure was 5.1 cm H2O (range, 1-18) and the mean pressure at maximal capacity was 37.4 cm H2O (range, 1-73).
The mean maximal flow rate was 17.8 ml / sec (range 3.1-24.5), the mean average flow rate was 11.4 ml / sec.
(range 1.9-14.6).
The mean first sensation volume was 310.1 ml (range, 171-471).
Conclusions: The detublarized sigmoid neobladder provides versatile and satisfactory results after radical Cystectomy.
It provides one stage total bladder substitution and is feasible with a very low morbidity.
Furthermore, the technique can be employed successfully for a cystec-tomized female patients.
American Psychological Association (APA)
Basyuni, Mahmud& al-Shirbini, Majdi& Murad, Ismail A.& Badawi, Ashraf& Muhammad, Abd al-Rahman. 2003. Detublarized sigmoid colon for total urinary bladder replacement : clinical outcome in 51 patients. Journal of the Egyptian National Cancer Institute،Vol. 15, no. 3, pp.201-208.
https://search.emarefa.net/detail/BIM-68467
Modern Language Association (MLA)
Basyuni, Mahmud…[et al.]. Detublarized sigmoid colon for total urinary bladder replacement : clinical outcome in 51 patients. Journal of the Egyptian National Cancer Institute Vol. 15, no. 3 (Sep. 2003), pp.201-208.
https://search.emarefa.net/detail/BIM-68467
American Medical Association (AMA)
Basyuni, Mahmud& al-Shirbini, Majdi& Murad, Ismail A.& Badawi, Ashraf& Muhammad, Abd al-Rahman. Detublarized sigmoid colon for total urinary bladder replacement : clinical outcome in 51 patients. Journal of the Egyptian National Cancer Institute. 2003. Vol. 15, no. 3, pp.201-208.
https://search.emarefa.net/detail/BIM-68467
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references : p. 207-208
Record ID
BIM-68467