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Front Surg 2021 7;8:751236. Epub 2021 Dec 7.

Department of Urology, The Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.

Recent studies employing functional imaging methodology have revealed reference brain regions of urinary tract function, namely, the midbrain periaqueductal gray matter, thalamus, and cingulate and prefrontal cortices. The orthotopic ileal neobladder is a desirable method for urinary diversion after radical cystectomy, but its supraspinal control remains unknown. We aimed to evaluate brain activity while maintaining urinary urgency and voluntary urinary control in male subjects with ileal orthotopic neobladders by performing functional MRI (fMRI) during a block design experiment. Read More

Int J Urol 2022 02 8;29(2):158-163. Epub 2021 Dec 8.

Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.

Objectives: To analyze the long-term effects of continent (neobladder) compared with incontinent (ileal conduit) urinary diversion.

Methods: We carried out a retrospective review of our departmental database. Estimated glomerular filtration rate was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. Read More

Can Urol Assoc J 2022 Feb;16(2):E102-E107

Department of Urology, Lenox Hill Hospital, Northwell Health, Zucker School of Medicine at Hofstra/Northwell, New York, NY, United States.

This systematic review summarizes the urinary continence, male sexual function, and female sexual function outcomes after robotic-assisted radical cystectomy (RARC). Greater intracorporeal diversion use, longer followup, and clearly stated urinary continence definitions have revealed RARC urinary continence rates for orthotopic ileal neobladders that are similar to those after open radical cystectomy (ORC) when using the strictest continence definitions. Nerve-sparing technique appears to be well-used in most studies, with short-term and long-term RARC potency rates similar those after ORC when using the strictest potency definitions. Read More

Urol J 2021 Apr 28;18(5):525-529. Epub 2021 Apr 28.

Department of Urinary Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China.

Purpose: This study aims to evaluate the effects of action research on neobladder function training in patients with orthotopic ileal neobladders.

Methods: A total of 68 patients with orthotopic ileal neobladders were randomly divided into two groups: a control group (31 patients) and an experimental group (37 patients). Patients in the control group received neobladder function training, while patients in the experimental group received neobladder function training based on the action research method. Read More

J Wound Ostomy Continence Nurs 2021 May-Jun 01;48(3):232-237

Kyle Merandy, DNP, ANP-BC, Department of Urology, New York Presbyterian Hospital/Weill Cornell Medical College, New York.

Purpose: The purpose of this study was to investigate the effect of a nurse practitioner-led simulation-based education program on nursing knowledge and confidence in the care of patients with a cutaneous continent urinary diversion (Indiana pouch) or orthotopic neobladder.

Design: Single-group, before-after study.

Subjects And Setting: The sample comprised 11 RNs practicing at New York Presbyterian Hospital in New York City. Read More

Arch Esp Urol 2021 Apr;74(3):351-354

Servicio de Urología. Hospital Universitario San Juan de Alicante. España.

Objective: Bacterial presence, anatomic anomalies and metabolic alterations increase the risk of stone formation in patients with neobladders. These patients sometimes require medical or surgical procedures. The aim of the current work is to analyze those alterations and medical treatment associated to it. Read More

Transl Androl Urol 2020 Dec;9(6):2541-2554

Department of Urology, University Hospitals Leuven, Leuven, Belgium.

Background: Radical cystectomy (RC) and urinary diversion (UD), with either an ileal conduit (IC) or an orthotopic neobladder (NB), is a complex surgery, in which various complications can occur. In this study, we compared postoperative complication rates after a RC and UD performed for the treatment of muscle-invasive bladder cancer or recurring high-risk non-muscle-invasive bladder cancer in our center.

Methods: We retrospectively included 604 patients that underwent UDs from December 1996 to August 2015. Read More

Can Urol Assoc J 2021 Aug;15(8):E386-E392

Division of Urology, Department of Surgery, Schulich School of Medicine & Dentistry, London, ON, Canada.

Introduction: This study aims to assess the longer-term functional, anatomical, and metabolic outcomes of patients who underwent Studer neobladder (SNB) urinary diversion.

Methods: A retrospective review of patients who underwent SNB at a single center from 1995-2017 (n=116) was performed. Demographics, comorbidities, pathological data, and longer-term functional, anatomical, and metabolic outcomes were collected from hospital records. Read More

J Robot Surg 2021 Jun 22;15(3):321-333. Epub 2020 Nov 22.

Department of Urology, University of Florida, 655 8th St W, Jacksonville, FL, 32209, USA.

Over the last decade, the increased utilization of robot-assisted radical cystectomy (RARC) in the surgical treatment of muscle-invasive bladder cancer has led to an uptrend in intracorporeal urinary diversions (ICUD). However, the operative results comparing ICUD to extracorporeal urinary diversion (ECUD) have varied widely. We performed a meta-analysis to analyze perioperative outcomes and complications of ICUD compared to ECUD following RARC. Read More

Eur Urol 2021 04 14;79(4):545-551. Epub 2020 Nov 14.

Department of Urology, Zhujiang Hospital, Southern Medical University, Guangzhou, China. Electronic address:

Background: Intracorporeal urinary diversion is considered to be effective in improving intestinal function recovery and reducing the occurrence of early complications after radical cystectomy. Almost all neobladders constructed via intracorporeal laparoscopy have used the ileum.

Objective: To present our intracorporeal detaenial sigmoid neobladder technique that replicates open surgery principles and to present oncological and functional outcomes and complication rates. Read More

Urol Oncol 2021 05 6;39(5):301.e11-301.e16. Epub 2020 Oct 6.

Department of Urology, Chinese PLA General Hospital, Beijing, China. Electronic address:

Objectives: To put forward a new index (A/G, the postoperative ratio of albumin to blood glucose) associated with complications occurring within 30-day of radical cystectomy and intestinal urinary diversion (RC-IUD).

Patients And Methods: The charts of 565 patients undergoing RC-IUD at our single center between 2008 and 2018 were reviewed. All baseline information and perioperative data were collected. Read More

J Robot Surg 2020 Dec 21;14(6):813-820. Epub 2020 Mar 21.

Urology Department, Sorbonne University, GRC n° 5, ONCOTYPE-URO, AP-HP, Hôpital Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013, Paris, France.

Robot-assisted radical cystectomy with intracorporeal urinary diversion is one of the most challenging procedures in urological surgery. Over the past 15 years, this procedure has gained in popularity and the number of procedures performed has increased significantly. While ileal conduit remains the most common diversion, orthotopic neobladders are also formed in a few expert centres that have developed their technique for totally intracorporeal neobladder. Read More

Turk J Urol 2019 11 1;45(Supp. 1):S150-S155. Epub 2019 Dec 1.

Department of Urology, Selçuk University School of Medicine, Konya, Turkey.

Bladder cancer is the most common malignancy of the urinary tract. Radical cystectomy with pelvic lymph node dissection and a urinary diversion (UD) is the gold standard treatment of non-metastatic muscle-invasive bladder cancer (MIBC). Although ileal conduit is the standard and most commonly performed type of UD, more number of centers have recently started to perform orthotopic ileal neobladder (OIN). Read More

F1000Res 2019 26;8. Epub 2019 Nov 26.

Division of Pediatric Urology, New York Presbyterian Hospital-Weill Cornell Medicine, New York, NY, 10065, USA.

Cystectomy and urinary bladder substitution are rare in children but may be necessary in some cases of bladder exstrophy, in the setting of malignancy, or in other settings in which the bladder is severely dysfunctional. This article details advances in surgical techniques in creating continent urinary diversions in this specialized pediatric population. Read More

World J Urol 2020 Jun 27;38(6):1413-1422. Epub 2019 Sep 27.

Department of Surgery, Austin Health, University of Melbourne, Melbourne, Australia.

Background: Urinary diversion procedures frequently result in bacterial colonisation. There is an increased incidence of developing urinary tract infections (UTIs) in this patient population. Current guidelines, however, recommend against treating this colonisation. Read More

Actas Urol Esp (Engl Ed) 2019 Jul - Aug;43(6):277-283. Epub 2019 Apr 26.

Departamento de Urología, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España.

Objectives: To compare perioperative outcomes and complications of robot assisted radical cystectomy (RARC) with extracorporeal (ECUD) vs. intracorporeal urinary diversion (ICUD) for bladder cancer.

Material And Methods: Retrospective revision of 43 patients who underwent RARC for bladder cancer between 2015-2018 with at least 3 months of follow-up. Read More

Scand J Urol 2019 Apr - Jun;53(2-3):81-88. Epub 2019 Apr 16.

a Department of Molecular Medicine and Surgery, Section of Urology , Karolinska Institut , Stockholm , Sweden.

Robot-assisted radical cystectomy (RARC) with intracorporeal orthotopic neobladder (ONB) can be recognized to be the supreme discipline in urological pelvic surgery. The utilization of RARC with intracorporeal urinary diversion (ICUD) has increased during the last 15 years. This increase is primarily noted for ICUD with ileal conduits, but with a lesser extent also for IC neobladders, with an increase from 7% in 2005 to 17% in 2016. Read More

Arch Esp Urol 2019 04;72(3):309-317

Hospital Universitario Puerta de Hierro. Madrid. Spain.

Objective: It is well known that RARC with intracorporeal diversion is being increasingly performed worldwide. In this article, we review the current situation of the intracorporeal neobladder.

Methods: We discuss the principles of intracorporeal orhotopic diversion, focusing on the most relevant: The Karolinska-modified Studer neobladder, the University of Southern California-modified Studer neobladder. Read More

Urol Int 2019 21;102(2):224-232. Epub 2018 Nov 21.

Department of Urology and Paediatric Urology, Julius Maximilians University Medical Center of Würzburg, Würzburg, Germany.

Purpose: The study aimed to evaluate the impact of the validated functional dexterity test and the Mini-Mental Status test on subjective functional outcomes, medical care situation, and health-related quality of life (HRQoL) after urinary diversion (UD).

Patients And Methods: A total of 106 patients (n = 26 ileal conduits, n = 29 neobladders, and n = 51 ileocecal pouches) were included in this combined retrospective (n = 77) and prospective (n = 29) observational study. All patients performed the 2 tests mentioned above and filled out self-designed questionnaires with diversion and HRQoL items. Read More

Int Braz J Urol 2018 Sep-Oct;44(5):914-919

Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul - PUC, Porto Alegre, RS, Brasil.

Introduction: We report on the surgical results of a series of 91 patients who received gastric neobladders as urinary diversion after radical cystectomies performed for the treatment of muscle-invasive bladder cancers.

Materials And Methods: We report on a retrospective case series of 91 patients who received gastric neobladders as urinary diversion after radical cystectomies performed for the treatment of muscle-invasive bladder cancers. Different techniques of gastric neobladders were employed from 1988 to 2013 at a university hospital in the South of Brazil. Read More

BJU Int 2018 03 11;121(3):458-465. Epub 2018 Jan 11.

Department of Urology, University College London Hospital, London, UK.

Objectives: To identify the rate of postoperative complications in patients who require surgical reconstruction for ketamine-induced urinary tract dysfunction and to identify any predictors for poor postoperative outcome with subsequent management strategies.

Patients And Methods: A retrospective review of data collected between 2007 and 2017 of all patients with ketamine-induced urinary tract disease was performed. Evaluation included computed tomography urogram, cystoscopy, and biopsy. Read More

Urology 2018 Apr 1;114:198-201. Epub 2017 Dec 1.

Oregon Health and Science University, Portland, OR.

Objective: To create a simple neobladder and determine whether the double-limb U-Pouch (D-LUP) has the same capacity and compliance as a Studer or Camey I neobladder. To develop an orthotopic diversion that can be applied to robotic surgery with laboratory data supporting the concept.

Materials And Methods: Kidneys, ureters, bladders, and small intestine were obtained from pigs at the time of scheduled autopsy after completion of institutionally approved investigational trauma protocols. Read More

Urol Clin North Am 2018 Feb;45(1):37-48

Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA. Electronic address:

Successful outcome with orthotopic neobladders begins in the preoperative phase with appropriate patient selection and extensive patient counseling. Meticulous attention to surgical and oncological principles is required to optimize neobladder outcomes. Long-term follow-up is needed not only for oncological purposes but also to monitor for the late complications, such as ureterointestinal strictures, renal deterioration, infections, and voiding dysfunction. Read More

J Robot Surg 2018 Jun 23;12(2):337-341. Epub 2017 Aug 23.

The University of Arizona College of Medicine - Phoenix, Phoenix, Arizona, USA.

Robotic-assisted radical cystectomy (RARC) with urinary diversion is commonly performed in community hospitals. While little data exist on RARC outcomes in this setting, community hospitals may improve access to care for bladder cancer patients. We conducted a retrospective review of 76 patients who underwent RARC between 2006 and 2016 by two robotic-trained surgeons in two local community hospitals. Read More

Nat Rev Urol 2017 Sep 4;14(9):565-574. Epub 2017 Jul 4.

Department of Urology, Guy's Hospital, Great Maze Pond, London, SE1 9RT, UK.

Muscle-invasive bladder cancer is an aggressive disease associated with high morbidity and mortality. Radical cystectomy is the mainstay of treatment and has evolved since the first reported cystectomy in 1887 to include pelvic lymph node dissection and the creation of increasingly sophisticated urinary diversions, such as neobladders and pouches, which enable patients to maintain continence. Pioneering work in the 1970s established the therapeutic activity of cisplatin in patients with bladder cancer and resulted in the introduction of cisplatin-based neoadjuvant chemotherapy, which led to the first improvement in survival outcomes in decades. Read More

Ren Fail 2017 Nov;39(1):379-384

a Division of Nephrology, Department of Internal Medicine.

Objectives: For many years, creation of an orthotopic neobladder after cystectomy has been popular. In the present study, we measured the extent of metabolic acidosis in patients with ileal neobladders compared with ileal conduits and defined risk factors for development of metabolic acidosis.

Methods: We retrospectively studied 95 patients, who underwent radical cystectomy and urinary diversion to treat invasive bladder cancer from January 2001 to December 2014 at Hallym University Kangnam Sacred Heart Hospital, through investigation of acid-base balance, serum electrolyte levels and renal function one month and one year after operation. Read More

Urology 2017 May 18;103:209-213. Epub 2017 Jan 18.

Department of Pediatric and Adolescent Urology, University Hospital Mannheim, Mannheim, Germany.

Objective: To report our experience of radical resection of secondary cancers after ureterosigmoidostomy. Ureterosigmoidostomy was the most common continent urinary diversion before the era of continent cutaneous diversion and neobladders, specifically in children. When performed for bladder exstrophy, patients will live with this kind of diversion for quite a long time. Read More

Int Urol Nephrol 2017 Jan 26;49(1):49-53. Epub 2016 Oct 26.

Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.

Purpose: To evaluate the necessity of chronic alkali therapy in non-complicated orthotopic ileal neobladders with normal renal function.

Materials And Methods: This is a prospective study that included 200 male patients who underwent radical cystectomy and ileal W neobladder for invasive bladder carcinoma between January 1993 and December 2013. The studied patients included 100 consecutive patients who were maintained on regular alkali therapy since surgery and 100 consecutive patients who stopped the use of alkali treatment after initial 3 months postoperative with minimum postoperative observation time of 1 year. Read More

Eur Urol 2018 06 22;73(6):934-940. Epub 2016 Oct 22.

Department of Urology, "Regina Elena" National Cancer Institute, Rome, Italy.

Background: Robot-assisted radical cystectomy (RARC) with intracorporeal neobladder reconstruction is a challenging procedure. The need for surgical skills and the long operative times have led to concern about its reproducibility.

Objective: To illustrate our technique for RARC and totally intracorporeal orthotopic Padua ileal bladder. Read More