A STUDY OF REFLUX IN PATIENTS WITH AN ILEAL ORTHOTOPIC BLADDER

Objective To determine whether there is vesico-ureteric reflux during voiding in patients who had undergone an ileal bladder substitution af ter cystectomy. Patients and methods The study comprised 15 patients ( 13 men and two women) who had undergone radical cystectomy and constru ction of a Studer ileal neobladder. At 1-24 months (median 4) after th e operation indirect radionuclide cystography (IRC) was performed afte r isotopic renography (using 99m-technetium mercapto-acetyltriglycine) and voiding cystourethrography (VCUG), Results None of the patients h ad reflux during voiding, either on IRC or on VCUG. Renal function and morphology remained stable in all patients, Despite bacteriuria occur ring in four patients, no episode of pyelonephritis was reported. Conc lusion There was no vesico-ureteric reflux during voiding in patients with a Studer ileal bladder substitution. However, long-term follow-up is needed to finally determine whether an antirefluxive ureteric impl antation is required to protect the upper urinary tract in patients wi th ileal low-pressure bladder substitutions.