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• W1972918275 abstract "No AccessJournal of UrologyAdult Urology1 Jul 2008Surgical Complications Following Radical Cystectomy and Orthotopic Neobladders in Womenis accompanied byEarly Cellular and Stromal Responses in Regeneration Versus Repair of a Mammalian Bladder Using Autologous Cell and Biodegradable Scaffold Technologies Bedeir Ali-El-Dein, Atallah A. Shaaban, Raeid H. Abu-Eideh, Mohamed El-Azab, Albair Ashamallah, and Mohamed A. Ghoneim Bedeir Ali-El-DeinBedeir Ali-El-Dein More articles by this author , Atallah A. ShaabanAtallah A. Shaaban More articles by this author , Raeid H. Abu-EidehRaeid H. Abu-Eideh More articles by this author , Mohamed El-AzabMohamed El-Azab More articles by this author , Albair AshamallahAlbair Ashamallah More articles by this author , and Mohamed A. GhoneimMohamed A. Ghoneim More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2008.03.080AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract 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. Materials and Methods: Between January 1995 and December 2003, 192 women with a mean age of 50.6 years received an orthotopic neobladder after radical cystectomy for bladder cancer. Standard radical cystectomy was done. Ileal reservoirs were used, mostly in the form of an ileal W-neobladder. We evaluated the patients for functional outcome, early and late complications, and treatment for these complications. Results: Two patients (1%) died of pulmonary embolism 1 to 2 weeks after cystectomy. Followup was 6 to 125 months (mean 54). Early complications included hemorrhage requiring reexploration in 1 case, postoperative blood transfusion in 1, wound infection in 8, prolonged ileus in 5, deep vein thrombosis in 5, pouch-vaginal fistula in 6, prolonged urinary leakage in 3, pouch-cutaneous fistula in 1 and early ureteral obstruction in 1. Of the 177 patients eligible for functional evaluation 62 experienced a total of 75 late complications, including stone disease in 18, ureteroileal stricture in 19, reflux in 22, intestinal obstruction in 2, incisional hernia in 2 and chronic pyelonephritis in 12. Early and late complications were treated accordingly with good outcomes. Conclusions: Early and late complications develop in a significant number of patients. Most early complications may be treated conservatively, while late complications are mostly treated with endourological and/or open surgery. Close lifelong surveillance of patients is mandatory to detect and properly treat these complications. References 1 : Lower urinary tract reconstruction following cystectomy: experience and results in 126 patients using the Kock ileal reservoir with bilateral ureteroileal urethrostomy. J Urol1991; 146: 756. Link, Google Scholar 2 : The ileal neobladder in women: 9 years of experience with 18 patients. J Urol1996; 155: 76. Link, Google Scholar 3 : Orthotopic lower urinary tract reconstruction in women using the Kock ileal neobladder: updated experience in 34 patients. J Urol1997; 158: 400. Link, Google Scholar 4 : Orthotopic bladder substitution in women: functional evaluation. J Urol1999; 161: 1875. Link, Google Scholar 5 : Metabolic and functional consequences of urinary diversion through intestinal segments. World J Urol2004; 22: 155. 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Abstract, Google Scholar Urology and Nephrology Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt© 2008 by American Urological AssociationFiguresReferencesRelatedDetailsCited byMcAlpine K, Lavallée L, Stacey D, Moodley P, Cagiannos I, Morash C, Black P, Kulkarni G, Shayegan B, Kassouf W, Siemens R, So A, Leveridge M, Boorjian S, Daneshmand S, Smith A, Power N, Izawa J, Drachenberg D, Fairey A, Rendon R and Breau R (2019) Development and Acceptability Testing of a Patient Decision Aid for Urinary Diversion with Radical CystectomyJournal of Urology, VOL. 202, NO. 5, (1001-1007), Online publication date: 1-Nov-2019.Bailey G, Blackburne A, Ziegelmann M and Lightner D (2016) Outcomes of Surgical Management in Patients with Stress Urinary Incontinence and/or Neovesicovaginal Fistula after Orthotopic Neobladder DiversionJournal of Urology, VOL. 196, NO. 5, (1478-1483), Online publication date: 1-Nov-2016.Movassaghi K, Shah S, Cai J, Miranda G, Fernandez J, Duddalwar V, Daneshmand S and Djaladat H (2016) Incisional and Parastomal Hernia following Radical Cystectomy and Urinary Diversion: The University of Southern California ExperienceJournal of Urology, VOL. 196, NO. 3, (777-781), Online publication date: 1-Sep-2016.Hussein A, Hashmi Z, Dibaj S, Altartir T, Fiorica T, Wing J, Durrani M, Binkowski J, Boateng L, Wilding G and Guru K (2015) Reoperations following Robot-Assisted Radical Cystectomy: A Decade of ExperienceJournal of Urology, VOL. 195, NO. 5, (1368-1376), Online publication date: 1-May-2016.Ferriero M, Guaglianone S, Papalia R, Muto G, Gallucci M and Simone G (2014) Risk Assessment of Stone Formation in Stapled Orthotopic Ileal NeobladderJournal of Urology, VOL. 193, NO. 3, (891-896), Online publication date: 1-Mar-2015.Anderson C, Cookson M, Chang S, Clark P, Smith J and Kaufman M (2012) Voiding Function in Women with Orthotopic Neobladder Urinary DiversionJournal of Urology, VOL. 188, NO. 1, (200-204), Online publication date: 1-Jul-2012.Hautmann R, de Petriconi R and Volkmer B (2011) 25 Years of Experience With 1,000 Neobladders: Long-Term ComplicationsJournal of Urology, VOL. 185, NO. 6, (2207-2212), Online publication date: 1-Jun-2011.George A, Srinivasan A, Cho J, Sadek M and Kavoussi L (2011) Surgical Site Infection Rates Following Laparoscopic Urological ProceduresJournal of Urology, VOL. 185, NO. 4, (1289-1293), Online publication date: 1-Apr-2011.Related articlesJournal of Urology21 May 2008Early Cellular and Stromal Responses in Regeneration Versus Repair of a Mammalian Bladder Using Autologous Cell and Biodegradable Scaffold Technologies Volume 180Issue 1July 2008Page: 206-210 Advertisement Copyright & Permissions© 2008 by American Urological AssociationKeywordsurinary diversionfemalecystectomybladderpostoperative complicationsMetrics Author Information Bedeir Ali-El-Dein More articles by this author Atallah A. Shaaban More articles by this author Raeid H. Abu-Eideh More articles by this author Mohamed El-Azab More articles by this author Albair Ashamallah More articles by this author Mohamed A. Ghoneim More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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