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- W2344114093 abstract "No AccessJournal of UrologyAdult Urology1 Oct 2016Patients with an Orthotopic Low Pressure Bladder Substitute Enjoy Long-Term Good Function Marc A. Furrer, Beat Roth, Bernhard Kiss, Daniel P. Nguyen, Silvan Boxler, Fiona C. Burkhard, George N. Thalmann, and Urs E. Studer Marc A. FurrerMarc A. Furrer More articles by this author , Beat RothBeat Roth More articles by this author , Bernhard KissBernhard Kiss More articles by this author , Daniel P. NguyenDaniel P. Nguyen More articles by this author , Silvan BoxlerSilvan Boxler More articles by this author , Fiona C. BurkhardFiona C. Burkhard More articles by this author , George N. ThalmannGeorge N. Thalmann More articles by this author , and Urs E. StuderUrs E. Studer More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.04.072AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Orthotopic bladder substitution has been performed on a regular basis for more than 30 years and yet data on long-term functional outcomes are still lacking. Materials and Methods: We evaluated 181 men and 19 women who underwent radical cystectomy and urinary diversion with ileal orthotopic bladder substitution from 1985 to 2004 and who had 10 years or more of followup. Results: Median age at radical cystectomy was 63 years (IQR 57–69). Median followup was 167 months (IQR 137–206). Daytime and nighttime continence rates peaked 24 months postoperatively and decreased slightly thereafter during almost 2 decades. At 10, 15 and 20 years daytime continence rates were 92%, 90% and 79%, and nighttime continence rates were 70%, 65% and 55%, respectively. During the day and at night fewer than 3% and 10% of patients, respectively, had urine loss 100 ml or greater at any time 10 years or longer after surgery. At 10 and 20 years 11 of 200 patients (6%) and 1 of 29 (3%), respectively, had to perform clean intermittent self-catheterization. After an initial postoperative decrease in the estimated glomerular filtration rate the subsequent decrease was less than 1 ml/minute/1.73 m2 per year. A total of 81 complications were observed in 42 of the 200 patients (21%) 10 years or longer after radical cystectomy with pyelonephritis as the most frequent cause. Conclusions: Patients who survive up to 20 years after radical cystectomy and diversion with an ileal orthotopic bladder substitution may enjoy satisfactory urinary continence and retain the ability to void spontaneously while experiencing no more than a physiological decrease in renal function. References 1 : Radical cystectomy for invasive bladder cancer: long-term results of a standard procedure. World J Urol2006; 24: 296. Google Scholar 2 : Twenty years’ experience with an ileal orthotopic low pressure bladder substitute - lessons to be learned. J Urol2006; 176: 161. Link, Google Scholar 3 : Radical cystectomy for carcinoma of the bladder: 2’270 consecutive cases 5 years later. J Urol2008; 180: 121. Link, Google Scholar 4 : 25 Years of experience with 1,000 neobladders: long-term complications. J Urol2011; 185: 2207. Link, Google Scholar 5 : The orthotopic neobladder. BJU Int2008; 102: 1307. 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Google Scholar © 2016 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byFurrer M, Kiss B, Studer U, Wuethrich P, Gahl B, Seiler R, Roth B, Bosshard P, Thomas B, Burkhard F, Boxler S and Thalmann G (2021) Seminal Vesical Sparing Cystectomy for Bladder Cancer is Feasible with Good Functional Results without Impairing Oncological Outcomes: A Longitudinal Long-Term Propensity-Matched Single Center StudyJournal of Urology, VOL. 205, NO. 6, (1629-1640), Online publication date: 1-Jun-2021.Hautmann R, Volkmer B, Egghart G, Frohneberg D, Gottfried H, Gschwend J, Hefty R, Kleinschmidt K, Küfer R, Miller K, de Petriconi R, Simon J and Wenderoth U (2020) Functional Outcome and Complications following Ileal Neobladder Reconstruction in Male Patients without Tumor Recurrence. More than 35 Years of Experience from a Single CenterJournal of Urology, VOL. 205, NO. 1, (174-182), Online publication date: 1-Jan-2021.Hautmann R (2017) Declining Use of Orthotopic Reconstruction Worldwide—What Went Wrong?Journal of Urology, VOL. 199, NO. 4, (900-903), Online publication date: 1-Apr-2018.Chang S (2017) Re: Orthotopic Neobladder vs. Ileal Conduit Urinary Diversion: A Long-Term Quality-of-Life ComparisonJournal of Urology, VOL. 198, NO. 6, (1207-1208), Online publication date: 1-Dec-2017.Johnson D and Pruthi R (2016) Urinary Reconstruction after Radical CystectomyJournal of Urology, VOL. 196, NO. 4, (979-980), Online publication date: 1-Oct-2016.Smith J (2016) This Month in Adult UrologyJournal of Urology, VOL. 196, NO. 4, (973-974), Online publication date: 1-Oct-2016. Volume 196Issue 4October 2016Page: 1172-1180 Advertisement Copyright & Permissions© 2016 by American Urological Association Education and Research, Inc.Keywordsurinary incontinencequality of lifeurinary diversioncystectomyelderlyMetricsAuthor Information Marc A. Furrer More articles by this author Beat Roth More articles by this author Bernhard Kiss More articles by this author Daniel P. Nguyen More articles by this author Silvan Boxler More articles by this author Fiona C. Burkhard More articles by this author George N. Thalmann More articles by this author Urs E. Studer More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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