Is chronic alkali therapy in orthotopic ileal neobladders necessary? A prospective controlled study.

Purpose: To evaluate the necessity of chronic alkali therapy in non-complicated orthotopic ileal neobladders with normal renal function.

Materials And Methods: This is a prospective study that included 200 male patients who underwent radical cystectomy and ileal W neobladder for invasive bladder carcinoma between January 1993 and December 2013. The studied patients included 100 consecutive patients who were maintained on regular alkali therapy since surgery and 100 consecutive patients who stopped the use of alkali treatment after initial 3 months postoperative with minimum postoperative observation time of 1 year.

Characterization of Standard Urine Properties in Noncomplicated Orthotopic Ileal Neobladders: A Prospective Controlled Study.

Objective: To characterize the standard physical, chemical, and microscopic characteristics of urine in patients with noncomplicated orthotopic ileal neobladders.

Materials And Methods: This is a prospective study that included 100 male patients who underwent radical cystectomy and ileal neobladder between 1993 and 2013. All included patients were in a good health and having satisfactory function of the reservoirs with normal upper tract with a minimum 1-year postoperative follow-up.

Vaginal repair of pouch-vaginal fistula after orthotopic bladder substitution in women.

Objective: To report the diagnosis, technique, and treatment outcome of pouch-vaginal fistula (PVF) with particular stress on the vaginal repair.

Methods: Between January 1995 and March 2010, 298 women (mean age, 52 years) underwent orthotopic neobladder reconstruction after radical cystectomy. A standard radical cystectomy was conducted in 283 patients and genitalia-sparing cystectomy in 15.

Surgical complications following radical cystectomy and orthotopic neobladders in women.

Purpose: Orthotopic neobladders have become the standard of care after radical cystectomy in select women with bladder cancer. We report early and late complications in 192 patients. Although medical complications were important, they were not the focus of this study.

Radical cystectomy for carcinoma of the bladder: 2,720 consecutive cases 5 years later.

Purpose: We performed a critical analysis of the results of radical cystectomy for invasive bladder carcinoma treated at 1 center.

Materials And Methods: Between 1970 and 2000, 2,090 men and 630 women with invasive bladder cancer were treated with 1-stage radical cystectomy and urinary diversion. Followup ranged from 0 to 34.

Local urethral recurrence after radical cystectomy and orthotopic bladder substitution in women: a prospective study.

Purpose: We prospectively studied the pathological outcome and incidence of urethral recurrence after radical cystectomy and orthotopic bladder substitution in women.

Materials And Methods: Between January 1995 and December 2001, 145 women with a mean age of 50 +/- 8.5 years underwent standard radical cystectomy and orthotopic substitution for bladder cancer.

Nocturnal enuresis in men with an orthotopic ileal reservoir: urodynamic evaluation.

Purpose: We evaluated the urodynamic features of enuretic and continent patients with an orthotopic neobladder.

Materials And Methods: Included in our study were 100 men with an orthotopic hemi-Kock or W neobladder and a minimum followup of 1 year. Of the patients 50 were completely continent day and night, and 50 had enuresis without evidence of an underlying organic etiology, such as stones, reflux or urethral stricture.

A prospective randomized study comparing absorbable and nonabsorbable staples in constructing antireflux valves of urethral hemi-Kock pouches.

Objective: To determine the long-term complications associated with constructing an antireflux nipple valve using absorbable or nonabsorbable staples in the urethral hemi-Kock pouch.

Patients And Methods: Fifty patients (all men, median age 47 years, range 28-73) undergoing construction of a urethral hemi-Kock pouch were randomized prospectively into two equal groups. In group 1, absorbable (polyglyconate) staples were used for the construction, and in group 2 nonabsorbable (metal) staples were used but omitting the staples applied at the tip of nipple valve.

Rectosigmoid urinary diversion: the functional significance of creating an intussuscepted colorectal valve.

Purpose: We assess the functional importance of a colorectal valve in patients with rectal urinary diversion.

Materials And Methods: A retrospective evaluation of 87 patients with an anal sphincter controlled bladder substitute was performed. Of these patients 42 had colorectal valves and 45 did not.

Radical cystectomy for carcinoma of the bladder: critical evaluation of the results in 1,026 cases.

Purpose: We performed a critical analysis of the different prognostic factors affecting survival among patients with carcinoma of the bladder for whom cystectomy was indicated. The different patient and tumor characteristics were correlated to survival data by a univariate as well as multivariate analysis.

Materials And Methods: Between 1969 and 1990, 764 men and 262 women, average age plus or minus standard deviation 43 +/- 8 years, with invasive carcinoma of the bladder were eligible for 1-stage radical cystectomy and urinary diversion.

Intravesical epirubicin versus doxorubicin for superficial bladder tumors (stages pTa and pT1): a randomized prospective study.

Purpose: We performed a prospective, randomized, controlled study to compare intravesical epirubicin and doxorubicin as adjuvant therapy after endoscopic resection of superficial bladder tumor.

Materials And Methods: We randomly allocated 253 eligible patients to 4 study arms. Seven to 14 days after transurethral bladder tumor resection instillation of the intravesical agent was instituted, including 50 and 80 mg.

Single-dose versus multiple instillations of epirubicin as prophylaxis for recurrence after transurethral resection of pTa and pT1 transitional-cell bladder tumours: a prospective, randomized controlled study.

Objective: To compare single-dose and multiple instillations of epirubicin in the chemoprophylaxis of superficial bladder tumours.

Patients And Methods: In a prospective randomized and controlled study, 168 evaluable patients were assigned to three groups after transurethral resection of bladder tumour (TURBT) and histological confirmation of its superficial nature (pTa and pT1). The groups were comparable for tumour stage, grade and other tumour characteristics.

Orthotopic bladder substitutes: histopathologic risk factors.

Prostate glands from 150 patients with carcinoma of the bilharzial bladder who underwent cystoprostatectomy were studied histopathologically by step sections. Prostatic urethral involvement by urothelial carcinoma was noted in 13 out of 96 (13.5%) and 5 out of 40 (12.

Further experience with the modified rectal bladder (the augmented and valved rectum) for urine diversion.

Continent diversion with the modified rectal bladder was done in 83 patients and 65 are currently evaluable with followup ranging from 6 to 36 months. There was no postoperative mortality and the morbidity rate was acceptable. Renal function and configuration were maintained in most patients (91%).

Optimization of replacement of the ureter by ileum.

Fifty patients for whom an ileal replacement of the ureter was indicated were prospectively randomized among 2 treatment groups according to the surgical technique used. In group 1 the standard operation was performed. In group 2 a tailored and valved (modified) ileal ureter was used.

Randomized trial of cystectomy with or without preoperative radiotherapy for carcinoma of the bilharzial bladder.

A prospective randomized clinical trial was done for 92 patients with carcinoma of the bilharzial bladder who underwent radical cystectomy alone or with 2,000 rad preoperative radiation. The postoperative mortality and morbidity were similar in both groups. Patients were followed for a minimum of 60 months.

Ileal replacement of the bilharzial ureter: is it worthwhile?

Our 14-year experience with the use of isolated ileal segments for replacement of the bilharzial ureter is analyzed retrospectively. Of 52 patients subjected to this procedure followup data were available for 38, in whom 52 ureters were repaired. The results generally were unsatisfactory: the morbidity and mortality rates were high and the percentage of functional improvement was low.

Evolution of the rectal bladder as a method for urinary diversion.

A critical analysis of previous reports reveals 2 main drawbacks of the rectal bladder: 1) recurrent pyelonephritis with subsequent loss of renal function (30 per cent) and 2) nocturnal urinary leakage (40 per cent). In a randomized prospective study the role of a submucosal tunnel for prevention of reflux was evaluated. We demonstrated objectively that this technique could provide a patent unidirectional flow of urine in the majority of cases (82.

Cystectomy for carcinoma of the bilharzial bladder: 138 cases 5 years later.

Our experience is outlined with 138 cases of bilharzial bladder cancer treated by radical cystectomy and followed for 5 years. The operative mortality was 13.7%.

Radical cystectomy for carcinoma of bilharzial bladder. Technique and results.

One hundred and sixty-two patients with carcinoma of the bilharzial bladder were treated by radical cystectomy. The postoperative mortality was 12.9 per cent and the five-year survival rate was 38.