INVERSION OF ORTHOTOPIC INTESTINAL URINARY RESERVOIR TO PREVENT TENSION IN URETHRA-RESERVOIR ANASTOMOSIS AFTER RADICAL CYSTECTOMY

Abstract

From 1995 to 2012 radical cystectomy were performed to 326 patients. Orthotopic intestinocistoplastika performed by Studer 69 (18.7%) patients, including short mesostenium was in 48 (69.6%), which are combined into two groups. Group I - 15 (31.3%) patients with orthotopic intestinocistoplasticy by Studer, II group - 33 (68.7%) patients who made modification techniques Studer - inverts orthotopic ileocistoplastics. Cases of leak of the tank or anastomosis were not observed. Medium capacity of neobladder after removal of urethral catheter – 110 ml., in 3 months – 350 ml, in 12 months – 490.0 ml. Maximum pressure in the tank does not exceed 40 cm water column (average 30 cm H2O). Day retention – 94,7%, night confinement at a forced night miction – 79.0%. The proposed method of inverting orthotopic ileal neobladder can be recommended when overlapping of orthotopic urinary reservoir is impossible or associated with leaks of the anastomosis due to the insuf-ficient length of the mesentery using known techniques of orthotopic ileal bladder reconstruction.

Keywords

• radical cystectomy
• orthotopic ileal bladder reconstruction