Ten years of orthotopic neobladder

Abstract

We present our ten years experience of orthotopic substitution of the bladder affected by infiltrating urothelial carcinoma in order to estimate a relatively small number of patients but with a long follow-up and to outline the reasons for our technical choices. Since January 1986 we have performed 70 orthotopic substitutions of the bladder, using the Carney I at the beginning and then passing on to the Carney II “detubularized” neobladder and in the following years the ileo-cecal bladder, the VIP till the “J” neobladder now preferred by the authors. Technically we have identified a series of parameters that we have used to evaluate the different types of neobladder. This examination shows that all the neobladders utilized are valid, but the “J” type corresponds much better to the current concept of ideal neobladder. We have illustrated and explained critically the patient selection principles and the results we obtained.