ORTHOTOPIC ILEAL NEOBLADDER IN FEMALE-PATIENTS AFTER RADICAL CYSTECTOMY - 2-YEAR EXPERIENCE

We describe a surgical technique to conserve urinary continence in 7 w omen who underwent radical cystectomy with construction of an orthotop ic ileal neobladder for infiltrating bladder carcinoma. The selection of the patients and the surgical procedure to preserve the anatomical and functional integrity of the female urethra are described. Followup ranged from 7 to 28 months. There were no postoperative deaths or ser ious clinical complications. The urinary continence rate was 100% duri ng the day and 71% at night with micturition at regular 3-hour interva ls. The vesical capacity varied from 250 to 400 cc and pressure at max imum capacity from 10 to 25 cm. water. Urinary flow was satisfactory a nd the urethral pressure profile showed a normal sphincteric mechanism at rest. Two patients died of metastases at 14 and 8 months postopera tively, and 5 are alive and disease-free. We believe that these result s confirm the possibility of obtaining micturition in women via the ur ethra following radical cystectomy.