FURTHER CLINICAL-EXPERIENCE WITH THE ILEAL W-NEOBLADDER AND A SEROUS-LINED EXTRAMURAL TUNNEL FOR ORTHOTOPIC SUBSTITUTION

Objective To report on the functional results following orthotopic substitution using an ileal W-neobladder with an extramural serous-lined tunnel for reflux prevention. Patients and methods Sixty men (mean age 46 years) underwent a one-stage radical cystoprostatectomy and an ileal W-neobladder for invasive bladder cancer, The technique entails the creation of two serous-lined extramural tunnels in a detubularized ileal Mr-bladder fashioned from 40 cm of the terminal ileum. Fifty-one patients were evaluable, with a minimum follow-up of 2 years, Evaluation of patients included clinical, radiographic and urodynamic studies. Results There was no operative mortality and no gross morbidity. The upper tracts remain unchanged or improved in 97% of the implanted renal units, Reflux was not observed in any patient, The incidence of day and night continence was 90 and 80%, respectively. Conclusion The technique provides a non-obstructed unidirectional uretero-ileal re-implantation, in a low-pressure system constructed from a short ileal segment, No staples were required.