BLADDER REPLACEMENT BY ILEOCYSTOPLASTY AFTER CYSTECTOMY FOR CANCER - COMPARISON OF 2 TECHNIQUES

Objective To compare two methods of connecting the meters to an ileocy stoplasty. Patients and methods Eighteen men with bladder cancer under went radical cystoprostatectomy and a further two had a subtotal cyste ctomy, all with immediate orthotopic bladder replacement by ileocystop lasty. In 10 patients, the ureters were connected to the neobladder by a length of ileum with an inverted nipple valve, while in the other 1 0 the meters were implanted directly using a serosal tunnel. Post-oper atively, the upper tracts were examined by intravenous urography and t he neobladder by cystography before removel of the catheter. Results T he direct implantation technique used 15 cm less ileum and took a mean of 1h less operating time to complete. The kidneys and ureters remain ed normal in all patients except one, who had a subtotal cystectomy an d developed severe hydronephrosis and hydrometer with acute renal fail ure when the inverted nipple valve became everted. Conclusions Whilst both techniques gave satisfactory results, direct implantation is mere economical in the length of ileum used and in operating time.