Abstract

Introduction: Construction of an ileal neobladder following radical cystectomy for bladder cancer has been more frequently applied within the last decade. Orthotopic bladder construction best mimics the native bladder regarding both location and function. We evaluated our results of Studer ileal neobladder after radical cystectomy for bladder cancer with a minimum 1 year follow up.

Materials and Methods: We performed Studer ileal neobladder after radical cystectomy in 31 patients (30 men, 1 woman) aged 35 to 72 between the years 1997 and 2002. Absolute contraindications for orthotopic diversion were serum creatinine level >1.7mg/dl, tumor at the urethral margin at surgery and presence of inflammatory bowel disease.

Results: The median follow up was 34 months (13-74). Early complications were; temporary cerebral hypoxia 1, depression 1, incisional detachment 1, wound infection 2, ileus 1 and vesico-cutaneus fistula 1 patient. Late complications comprised of incisional hernia in 2, anastomotic stricture in 1 and vesico-cutaneus fistula in1 patient. All patients except one are continent during day (%97). Urethral recurrence was seen in 2 (%6.2) and local recurrence in 1 patient (%3.1).

Of the 10 patients who underwent a nerve sparing radical cystectomy, 6 patients have erections postoperatively: 2 spontaneous, 2 with sildenafil citrate and 2 with intracavernosal injection. Renal deterioration due to surgical complications was not detected in any renal system.

Conclusion: The results of Studer ileal neobladder with a median 3 year follow up are favorable with an acceptable complication rate. The success rate regarding function of the bladder is high and the outcome of upper urinary tract is excellent. Patient cooperation remains of paramount importance for a successful outcome.