DETUBULARIZED U-SHAPED ENTEROCYSTOPLASTY AFTER CYSTOPROSTATECTOMY

We reviewed the charts of 58 patients who underwent orthotopic bladder replacement after total cystoprostatectomy for muscle invasive bladde r cancer, Mean age was 56 years. As described by Camey, 60 centimetres of small bowel, are isolated, detubularised then folded upon itself t o form a U shaped reservoir, which is anastomosed to the urethra. Deat h occurred in 5%. Urologic complications observed were : urinary leaka ge (15%), ureteral reflux (6.8%), ureteral stenosis (8.6%) and stones of the neobladder (5.1%). 64.2% of the patients were immediately conti nent during the day. Nocturnal continence was obtained for 50% immedia tely and for 80% three months postoperatively. Detubularised and U sha ped cystoplasty achieve a low pressure reservoir, with protection of t he upper urinary tract, and a diurnal continence. Nocturnal continence is achieved later.