Objective: The purpose of this study was to evaluate early and late complications, reservoir functional outcome, continence status and upper tract functional throughout the follow up after Studer ileal neobladder
Patients and methods: Thirty two patients were included in this study and followed at a regular interval of three months for one year postoperatively. Early and late complications, urinary continence and upper tract configuration and function were evaluated. Patients were assessed by interviews and history taking, voiding diary, continence questionnaire, abdominopelvic ultrasound, IVU and urodynamic study.
Results: No postoperative mortality. Early and late postoperative complications rates were 28.1% and 12.5% respectively. Out of 32 patients, febrile urinary tract infection occurred in 4 patients, prolonged urinary leakeage in 2 patients, unilateral hydronephrosis in 3 patients, urethroileal stricture in 3 patients, and metabolic acidosis in one patient. The mean functional pouch capacity increased over time from 298±65ml at 3month postoperatively to 423±93 at 9 month of follow up and became fixed thereafter. The mean post voiding residual urine estimated by ultrasound was 46±18 at 6 month of follow up. All patients underwent urodynamic evaluation at 6 and 12 month postoperative. The maximal pouch capacity was 395±75 ml with the pouch pressure at maximal capacity was 30±6 cm water at 6 month postoperative with similar value at 12 month and thereafter. Continence status improved over time, meanwhile the night time continence rate was lower than daytime, unsatisfactory night continence who need more than one pad per night was recorded in 12.5% then reduced to 3.1% at 6 month and 12 month postoperative respectively .IVU at 6 month show no upper tract ectasia or dilatation in all patients through out next follow up period
Conclusion: Studer ileal neobladder is easy and satisfactory surgical technique of orthotropic urinary diversion. It provides an acceptable rate of postoperative complications with good functional reservoir outcome and continence status while preserving upper tract function. |
