[Mid-long-term follow-up of radical cystectomy with orthotopic ileal neobladder in women patients with bladder carcinoma].

Objective: To assess the mid-long-term efficacies of orthotopic urinary diversion in women.

Methods: From February 2003 to August 2012, 28 female patients with bladder cancer underwent radical cystectomy and orthotopic ileal neobladder.Open (n = 18) and laparoscopic (n = 9) procedures were performed.Ileal neobladder included 17 T-pouch and 11 modified Studer pouch reconstruction. The continence status, urodynamics, serum electrolyte and renal function were followed up.

Results: The mean follow-up period was 55 (8-114) months.Excellent continence was achieved during day-time in 82.1%, 92.3% and 90.5% cases at 6, 12 and 24 months postoperatively and in 53.6%, 88.5% and 90.5% cases at night respectively. The mean capacity of pouch was 282 ± 87, 345 ± 72 and 357 ± 75 ml at 6, 12 and 24 months postoperatively respectively. The mean filling pressure of pouch was 10.8 ± 3.2, 6.7 ± 2.6 and 6.2 ± 2.1 cmH₂O postoperatively respectively.One case of neobladder-vaginal fistula was cured by surgical repair. Another case of urethral stenosis responded well after regular dilation for 6 months.Renal function and electrolyte metabolism were stable in all cases. There was no instance of tumor recurrence or metastasis.

Conclusion: Orthotopic urinary diversion in females has excellent long-term results with fewer complications so that it is highly recommended.