EARLY AND LATE CYSTOMETRY OF DETUBULARIZED AND NONDETUBULARIZED INTESTINAL NEOBLADDERS - NEW OBSERVATIONS AND PHYSIOLOGICAL CORRELATES

Purpose: We studied the volume and pressure changes with time in detub ularized and nondetubularized neobladders. Materials and Methods: Cyst ometry was performed at early and late followup in 54 male patients wi th post-cystectomy intestinal neobladders constructed from an intact i leocecal segment in 33, detubularized sigmoid in 11 and detubularized ileum in 10. Results: With time the capacity of the neobladder increas ed in all 3 groups. Concomitantly, while intact ileocecal bladders sho wed an increase in intra-reservoir pressure and persistence of involun tary contractions, detubularized sigmoid and ileal bladders showed a d ecrease in intrareservoir pressure and involuntary contractions. Concl usions: Increased capacity with time is not due to detubularization pe r se but rather to over distension, which is more marked in detubulari zed (109 to 112%) than in tubular (79%) segments. Detubularized intest inal neobladders not only offer a high capacity, low pressure and high compliant reservoir but these characteristics also are increased with time.