Orthotopic ileal neobladder in females: Impact of the urethral resection line on functional results

We present our functional experience with orthotopic dependent November 198 6 and July 1998 42 women underwent orthotopic urinary tract reconstruction with an ileal neobladder at our institution: 26 patients underwent radical cystectomy (RCx) with subsequent ileal anastomosis to the urethra. and 16 u nderwent simple cystectomy (SCx) with preservation of the bladder neck. Fou rteen of 22 patients following RCx and 3 of 14 patients following bladder n eck-sparing cystectomy void naturally. Clean intermittent catheterization i s necessary in 8 of 22 and 11 of 14 patients, respectively. Perfect contine nce with no pads at 1 year postoperatively was achieved in 15 of 18 evaluab le patients following RCx and 10 of 11 patients following bladder neck spar ing. Incontinence requiring one or more pads is present in 3 of 18 patients and 1 of II patients, respectively. Subjectively satisfactory continence w as achieved in 16 of 18 patients following RCx and in all patients followin g bladder neck-sparing surgery. Our conclusions are that radical cystectomy as well as a bladder neck-sparing cystectomy does provide satisfactory fun ctional results in the majority of patients. the urethral resection line do es slightly patients Between bladder replacement in female on the urethral resection line. However, influence the rate or incontinence as well as the requirement for intermittent catheterization. RCx does translate into a les ser requirement for CIC, whereas bladder neck sparing results in slightly b etter continence rates.