Neobladder after Cystectomy: An Indian Experience

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Abstract
A continent urinary reservoir was constructed from an ileocolonic segment and anastomosed to the urethra in 30 males after radical cystectomy for infiltrating bladder cancer. A small cuff of the prostate was retained for anastomosis with the reservoir and ureteric anastomosis was done from within the reservoir by the "pull through" method. Complete continence was achieved in 29 patients, all of whom had an adequate reservoir capacity exceeding 400 ml; they were able to empty the reservoirs satisfactorily as judged by the residual urine (< 50 ml). Urodynamic study revealed an intra-abdominal pressure < 30 cm of water at rest and at reservoir capacity of 500 ml. Early post-operative complications included urinary leaks in 3 patients, intestinal obstruction in 3 and a faecal fistula in 1. Deterioration of the upper tracts was noted in 5 cases. Twenty-seven patients are alive after a mean follow-up of 36 months.