Assessment of morbidity and functional results in bladder replacement withHautmann ileal neobladder after radical cystectomy: A clinical experience in 55 highly selected patients

Objectives. To analyze the morbidity and functional results of the ileal ne obladder in a series of 55 highly selected patients. The ileal neobladder i s a commonly used technique for orthotopic bladder reconstruction after rad ical cystectomy in both sexes. Good results have been published from Ulm Un iversity, where the technique was popularized. Methods. From February 1994 to June 2000, 55 patients (47 men and 8 women), 32 to 75 years old (mean age 58) with good performance status (American So ciety of Anesthesiologists score 1 and 2), underwent radical cystectomy for bladder cancer and Hautmann ileal neobladder reconstruction. Functional as sessments were done at 3 months and every 6 months thereafter, with special attention to urinary continence and upper urinary tract status. Results. The median follow-up was 28.8 months (range 8 to 96). One perioper ative death occurred. Early complications occurred in 23.6% without repeate d surgery and late complications occurred in 25.4%, with three repeated ope rations for occlusive syndromes. The daytime and nighttime continence rates at 3, 6, and 12 months were 59.6%, 80.8%, and 88.5% and 38.5%, 61.5%, and 78.8%, respectively. The overall continence rate in patients younger than 7 0 years old was 80.8%. Three patients required self-catheterization to empt y their neobladder. Eleven patients died of metastatic evolution of their b ladder cancer or intercurrent disease at 6 to 36 months. Conclusions. In highly selected patients, the ileal neobladder provides goo d functional results regarding continence with an acceptable complication r ate. In this series, the results were comparable to those reported in the r eferent institution. (C) 2001, Elsevier Science Inc.