Urodynamic evaluation of urine reservoir function after sigmoid or ileal neobladders oepration

Objective:To evaluate and compare the urodynamic parameters and continence rate of urine reservoir function among patients who had undergone orthotopic bladder substitution with sigmoid or ileal segments. Methods:Continent urinary reservoirs were constructed in 73 patients. Thirty-three patients were received a sigmoid neobladder (SN) and 40 patients with an ileal neobladder (IN). All patients were examined urodynamically and taken intravenous pyelography to test their continence status. Urodynamic parameters and continence were obtained. Results:Complete follow-up was performed in 73 cases 12 months averagely postoperatively. The patients were examined after 3-6 months. There was no perioperative fatality cases. The average reservoir capacity of IN(485±60) ml was higher than of SN(350±52) ml(P<0.01),the bladder filling pressure and urination bladder pressure were lower than of IN(P<0.01). The urination continence ability was satisfied in the two groups. Daytime continence was 87.5% in IN group and 90.9% in SN group,nighttime continence was 65.0% in IN group and 48.5% in SN group(P>0.05). Two cases of hydronephrosis with mild impaired renal function were found in SN. Conclusions:A neobladder constructed from detubularized ileum or sigmoid achieves adequate reservoir capacity,accepted urodynamics with a satisfactory daytime continence rate. Nighttime incontinence in patients with IN and SN is still a vexed problem.