177 results match your criteria Urinary Diversions and Neobladders


[Metabolic alterations and stones in patients with orthotopic ileal diversions. Case description.]

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

View Article and Full-Text PDF

Comparison of postoperative complications of ileal conduits versus orthotopic neobladders.

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

View Article and Full-Text PDF
December 2020

Longitudinal experience with Studer neobladders: Outcomes and complications.

Can Urol Assoc J 2021 Jan 4. Epub 2021 Jan 4.

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

View Article and Full-Text PDF
January 2021

Intracorporeal versus extracorporeal urinary diversion following robot-assisted radical cystectomy: a meta-analysis, cumulative analysis, and systematic review.

J Robot Surg 2020 Nov 22. 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

View Article and Full-Text PDF
November 2020

Initial Experience with Intracorporeal Laparoscopic Radical Cystectomy and Detaenial Sigmoid Neobladder Reconstruction.

Eur Urol 2021 Apr 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

View Article and Full-Text PDF

A new index (A/G) associated with early complications of radical cystectomy and intestinal urinary diversion.

Urol Oncol 2020 Oct 6. 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

View Article and Full-Text PDF
October 2020

Functional outcomes obtained with intracorporeal neobladder after robotic radical cystectomy for cancer: a narrative review.

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

View Article and Full-Text PDF
December 2020

First experience with a new form of orthotopic ileal neobladder (Leuven N-Pouch) following radical cystectomy.

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

View Article and Full-Text PDF
November 2019

Advances in bladder substitution and creation of neobladders in children.

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

View Article and Full-Text PDF
January 2020

Systematic review: bacterial colonisation of conduits and neobladders-when to test, watch, and treat.

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

View Article and Full-Text PDF

Comparison of perioperative outcomes and complications of robot assisted radical cystectomy with extracorporeal vs intracorporeal urinary diversion.

Actas Urol Esp 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

View Article and Full-Text PDF
September 2020

Clinical outcomes of robot-assisted radical cystectomy and continent urinary diversion.

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

View Article and Full-Text PDF
January 2020

Intracorporeal neobladder.

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

View Article and Full-Text PDF

Cognitive Status and Functional Dexterity as Outcome Predictors Following Urinary Diversion: A Combined Retrospective and Prospective Observational Study.

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

View Article and Full-Text PDF

Gastric neobladders: surgical outcomes of 91 cases using different techniques.

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

View Article and Full-Text PDF
December 2018

The effects of recreational ketamine cystitis on urinary tract reconstruction - a surgical challenge.

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

View Article and Full-Text PDF

A Simple Neobladder Using a Porcine Model: The Double Limb U-Pouch.

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

View Article and Full-Text PDF

Male Neobladder.

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

View Article and Full-Text PDF
February 2018

Surgical and pathological outcomes of robotic-assisted radical cystectomy for bladder cancer in the community setting.

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

View Article and Full-Text PDF

Landmarks in the treatment of muscle-invasive bladder cancer.

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

View Article and Full-Text PDF
September 2017

Acid-base disorders after orthotopic bladder replacement: comparison of an ileal neobladder and an ileal conduit.

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

View Article and Full-Text PDF
November 2017

Adenocarcinoma in Continent Anal Urinary Diversion: Is a Sigma Rectum Pouch a Surgical Option After Failed Ureterosigmoidostomy?

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

View Article and Full-Text PDF

Is chronic alkali therapy in orthotopic ileal neobladders necessary? A prospective controlled study.

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

View Article and Full-Text PDF
January 2017

Robotic Intracorporeal Padua Ileal Bladder: Surgical Technique, Perioperative, Oncologic and Functional Outcomes.

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

View Article and Full-Text PDF

Characterization of Standard Urine Properties in Noncomplicated Orthotopic Ileal Neobladders: A Prospective Controlled Study.

Urology 2016 Oct 11;96:80-84. Epub 2016 Jul 11.

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

Objective: To characterize the standard physical, chemical, and microscopic characteristics of urine in patients with noncomplicated orthotopic ileal neobladders.

Materials And Methods: This is a prospective study that included 100 male patients who underwent radical cystectomy and ileal neobladder between 1993 and 2013. All included patients were in a good health and having satisfactory function of the reservoirs with normal upper tract with a minimum 1-year postoperative follow-up. Read More

View Article and Full-Text PDF
October 2016

Intravesical OnabotulinumtoxinA Injection for Overactive Orthotopic Ileal Neobladder: Feasibility and Efficacy.

Int Neurourol J 2016 Mar 7;20(1):81-5. Epub 2016 Mar 7.

Department of Urology, Austin Hospital, University of Melbourne, Melbourne, Australia.

The efficacy of intravesical onabotulinumtoxinA (BTXA) in the treatment of overactive bladder (OAB) has been well documented. The use of BTXA injection in orthotopic neobladders is yet to be studied. We present 4 cases of patients injected with intravesical BTXA for overactive orthotopic ileal neobladder. Read More

View Article and Full-Text PDF

Ileal versus sigmoid neobladder as bladder substitute after radical cystectomy for bladder cancer: A meta-analysis.

Int J Surg 2016 Mar 20;27:39-45. Epub 2016 Jan 20.

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

Purpose: To evaluate and compare the functional outcomes of ileal and sigmoid neobladders in patients underwent radical cystectomy.

Methods: Relevant studies were identified by searching PubMed, Embase, and Cochrane Library. The studies comparing the functional outcomes of sigmoid neobladder (SN) and ileal neobladder (IN) in patients underwent radical cystectomy were included. Read More

View Article and Full-Text PDF

Stapled orthotopic ileal neobladder after radical cystectomy for bladder cancer: Functional results and complications over a 20-year period.

Eur J Surg Oncol 2016 Mar 2;42(3):412-8. Epub 2015 Dec 2.

Department of Urology, San Giovanni Bosco Hospital, Turin, Italy. Electronic address:

Aims: To present the long term-results and complications of a large series of stapled ileal orthotopic neobladders.

Materials And Methods: From 1992 to 2012 we performed 606 radical cystectomies with stapled orthotopic neobladder substitution in male patients. The median patient age was 65 years (interquartile range [IQR]: 58-71). Read More

View Article and Full-Text PDF

The role of cystectomy in elderly patients - a multicentre analysis.

BJU Int 2015 Oct 2;116 Suppl 3:73-9. Epub 2015 Sep 2.

Department of Surgery, University of Melbourne, Heidelberg, Vic., Australia.

Introduction: Life expectancy in developed countries is continuously increasing. Hence elderly patients are becoming more common in our clinical practice. Currently, one of the greatest challenges of medicine is balancing the life expectancy of elderly patients against aggressive treatments that carry significant risks. Read More

View Article and Full-Text PDF
October 2015