Ten years of orthotopic bladder substitution: An analysis of surgical complications

Abstract

We analysed the more common surgical complications we have noticed during our ten years experience of orthotopic bladder substitution. The critical review assesses these complications in relation to the different types of bladder substitution we used, beginning from Carney I up to the so-called “J” neobladder, following the natural development of our surgical technique from 1986 to the present (Carney II, ileo-cecal bladder, VIP). We described the early and late complications, carefully pointing out those known to be the most dangerous: enteric fistula, urinary fistula and ureteral reflux. We also reported the corrective treatments adopted and the preventive protocols we could eventually adopt in order to show if there are any technical methods that can significantly reduce the incidence of the above-mentioned complications.