THE IMPACT OF A MODIFIED ILEAL NEOBLADDER ON THE LIFE-STYLE AND VOIDING PATTERNS IN ASIAN PATIENTS

Objective To evaluate the impact of the modified ileal neobladder reco nstruction on lifestyle, voiding habits and functional outcome in Asia n patients. Patients and methods Twenty-seven Asian patients (25 men a nd two women, mean age 59 years, range 41-76) underwent modified ileal neobladder reconstruction after radical cystectomy for carcinoma of t he bladder, The mean (range) follow-up was 21 (3-75) months, All patie nts were evaluated retrospectively using case notes, reviews, intervie ws and voiding charts; 18 patients underwent urodynamic studies. Resul t Twenty-five patients (93%) achieved diurnal and 23 (85%) nocturnal c ontinence within 6 months. Of the 19 patients who were in employment b efore surgery, 15 continued to be economically active afterward; 26 pa tients (96%) reported no change in their daily living activities. Of 1 6 men who reported being potent pre-operatively only four retained som e residual erectile function. Twenty-three patients were interviewed a bout their voiding habits and satisfaction with the outcome of surgery , Fourteen patients had no sensation of reservoir fullness and of the 21 men, 13 had to squat or sit to void effectively. The mean (range) v oiding frequency was 5 (4-8) during the day and 2 (0-4) during sleep. Twenty-two patients were satisfied with the overall outcome, Conclusio ns The modified ileal bladder provides a high urinary continence rate with minimal changes in daily living activities and occupational statu s. The functional outcome was very satisfactory and accepted well, des pite some changes in reservoir sensation, voiding posture and erectile function. The method is a viable option for reconstruction after cyst ectomy in Asian patients.