Causes and treatment of residual urine volume after orthotopic gladder replacement in women

Objectives: Intact innervation of the female urethra is conditional for nor mal urination, in the past, urethrectomy was performed as part of cystectom y. After intense anatomical studies of the female pelvis, urethral-function -sparing cystectomy was developed, Methods: Our clinical group consists of 41 female patients who were operate d from 1993 to 1998 for bladder cancer, utilizing cystectomy with orthotopi c bladder replacement. Results: In 28 patients, complete daytime continence was restored and in 13 patients, daytime continence was socially satisfactory (1-2 pads were used due to mild stress incontinence), The drawback of orthotopic replacements in females is the frequent development of serious residual volume, which wa s seen in onethird of the 41 patients. The functional results of orthotopic neobladders and therapy of residual urine volume were documented using uro dynamic studies. Conclusions: Postvoiding residual volume may be caused by isolated dysfunct ion of the urethra and can be treated with clean intermittent self-catheter ization or with alpha -blockers, which improve evacuation of the neobladder . Copyright (C) 2000 S. Karger AG, Basel.