FEMALE URETHRA-SPARING CYSTECTOMY AND ORTHOTOPIC BLADDER REPLACEMENT

Objective: Orthotopic bladder replacement after cystoprostatectomy has long become the method of choice in the treatment of infiltrating bla dder cancer in males. Very good quality of life in patients thus treat ed stimulated the work on a similar approach applicable to females. Me thods: Twelve females were treated by urethra-sparing cystectomy. The surgical technique preserves not just the urethra itself but also the pelvic floor and relevant innervation. Results: Diurnal continence was achieved in 11 patients, 1 of whom had a so-called hypercontinence wi th a residual volume of 300 mi. The remaining patient suffered from st ress incontinence. Conclusion: The described urethra-sparing radical c ystectomy in female patients with a urothelial tumor, with normal pelv ic floor and with a low risk of secondary affection of the urethra, pe rmits reconstructing a continent orthotopic neobladder from a detubula rized intestinal segment.