Orthotopic ileal bladder substitution in female patients: Our experience

Abstract

Orthotopic bladder reconstruction in women was introduced to guarantee voluntary micturition via the urethra as already obtained in men. A meticulous urethra-sparing surgical procedure and a low-pressure reservoir allow urinary continence to be preserved. Careful selection of patients can reduce the already low risk of urethral relapse. An orthotopic ileal neobladder was performed in 8 women following radical cystectomy for infiltrating bladder carcinoma. Follow-up ranged from 10 to 47 months. There were no serious clinical complications. At 6 months the complete urinary continence rate was 100% during the day and 75% at night with 4-hour interval voiding. At 12 months neobladder capacity varied from 250 to 400 ml and pressure at maximum capacity from 8 to 25 cm water. Urodynamic parameters were stable over a period of time. Four patients died of distant metastasis and 4 are alive and disease-free. In our opinion an orthotopic ileal neobladder in women gives excellent functional results and is a satisfactory option in selected female patients.