BEHAVIOR AND URODYNAMIC PROPERTIES OF ORTHOTOPIC ILEAL BLADDER SUBSTITUTE AFTER RADICAL CYSTECTOMY

The study included 18 men, submitted to urodynamic investigation 9-18 months after cystoprostatectomy for bladder cancer and bladder substit ution with a detubularized ileal segment as described by Studer-Zingg. Sixteen patients were continent by day and 3 were incontinent during the night so as to require the use of a condom catheter. The residual urine was over 100 ml in 3 patients, while it was low or absent in the remainder. Micturition was performed by straining, and maximal flow r ates were normal, although the pattern was intermittent. The incidence of nocturnal incontinence was 55.5%. Measurement of the urethral pres sure profile revealed a shortened functional length, and low pressure was found in 3 patients, with a maximum urethral closure pressure <45 cm H2O. During extramural ambulatory urodynamic monitoring, pressure v alues in the neobladder usually ranged below 20 cm H2O and exceeded 34 cm H2O in only 2 patients who complained of daytime and nocturnal inc ontinence. The urodynamic features of the neobladder in patients who u nderwent radical cystoprostatectomy and bladder replacement with a det ubularized ileal segment indicate low pressure at high-level filling.