Twelve patients are submitted to orthotopic ileal neobladder, performed using staplers. The simplicity and speed of automatic stapling devices in the Rouxel-Coadou's surgical technique are reported. All patients underwent clinical and urodynamic evaluation at 3, 6, 12 months, after surgery (mean follow-up 6 months). They preferred complete daytime continence and 2 pts/4 night-time continence too. At one year, postvoid residual volume was absent, mean neobladder capacity was 450 ml and mean pressure at maximum capacity was 30-40 cm H2O. These preliminary results indicate that this technique guarantees a low-pressure reservoir with good capacity and compliance.
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Int J Urol
January 2025
Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Introduction: Bowel regimens (BR) before radical cystectomy (RC) are currently not recommended by Enhanced Recovery After Surgery (ERAS) protocols, as prior studies have shown BRs lead to worsened outcomes. However, many of those studies have used historic literature before recent surgical advancements such as minimally invasive RC and have not investigated the impact BRs have by type of urinary diversion. Our goal is to determine the outcomes of preoperative BR in patients undergoing RC based on diversion type using a modern patient cohort.
View Article and Find Full Text PDFAnn Surg Oncol
December 2024
Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada.
Objective: This study aimed to compare adverse in-hospital outcomes in ileal conduit versus neobladder urinary diversion type after radical cystectomy (RC) in contemporary versus historical patients.
Methods: Patients were identified within the National Inpatient Sample (NIS 2000-2019). Propensity score matching (PSM; 1:2 ratio) and multivariable logistic regression models (LRMs) were used.
World J Urol
December 2024
Department of Urology, Bichat Claude Bernard Hospital, Paris Cité University, 46 rue Henri Huchard, Paris, 75018, France.
Objective: To compare surgical parameters and short-term outcomes between open radical cystectomy (ORC) and robotic radical cystectomy with total intracorporeal urinary diversion (icRARC).
Methods: Among the study period, 133 patients who underwent ORC and pelvic node dissection for bladder cancer (group 1) were matched and compared to 61 patients who underwent icRARC during the same period (group 2). The groups were matched 1:1 according to their propensity scores adjusted on their baseline demographics and disease characteristics.
Int J Surg Case Rep
December 2024
Radiology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Introduction And Importance: Orthotopic neobladder reconstruction may be associated with complications such as neobladder-vaginal fistula (NVF) and uretero-ileal anastomotic stricture which are often managed using stents, though these can be prone to migration.
Case Presentation: We present a 69-year-old lady with a surgical history of radical cystectomy and ileal neobladder that was complicated by a left ureteric stricture and poucho-vaginal fistula for which she underwent a left ureteric stent and bilateral percutaneous nephrostomy (PCN) insertions after which she lost to follow-up. The patient later presented to our center with a right subcostal anterior abdominal wall desmoid tumor for which she underwent wide local excision.
BMJ Case Rep
November 2024
Department of Urology, Hospital Alemán, Buenos Aires, Argentina.
We describe a case of ureteral stricture after radical cystectomy with orthotopic neobladder. The patient presented 4 months after laparoscopic radical cystectomy with intracorporeal orthotopic ileal neobladder, with fever and left lower back pain.Laboratory analysis showed leucocytosis and elevated C reactive protein and creatine levels.
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