Reddy P K, Lange P H, Fraley E E
Department of Urologic Surgery, University of Minnesota Hospital and Clinic, Minneapolis.
J Urol. 1991 Jan;145(1):51-5. doi: 10.1016/s0022-5347(17)38245-9.
We performed total bladder replacement with a detubularized segment of sigmoid colon in patients after cystoprostatectomy. The surgical technique and long-term results in 27 patients are reported. This neobladder configuration compared favorably with other neobladder types regarding ease of construction. The surgical complications were acceptable. Initial reservoir function was good but improved further with time. After 1 year the capacity averaged 600 cc, pressures during filling and at capacity were low (average 12 and 16 cm. water) and emptying was satisfactory (residual urine 4 to 80 cc). All patients were continent during the day and 67% were continent at night without excessive voiding habits. Nighttime incontinence was further resolved in 2 patients by using the AMS 800 artificial sphincter around the bulbous urethra. The detubularized sigmoid is an excellent neobladder configuration after cystoprostatectomy.
我们对膀胱前列腺切除术后的患者采用去管化乙状结肠段进行全膀胱置换。报告了27例患者的手术技术及长期结果。就构建的简易程度而言，这种新膀胱构型与其他类型的新膀胱相比具有优势。手术并发症在可接受范围内。最初的储尿囊功能良好，但随着时间推移进一步改善。1年后，容量平均为600 cc，充盈期及充盈至容量时的压力较低（平均12和16 cm水柱），排空情况令人满意（残余尿量4至80 cc）。所有患者白天均能控尿，67%的患者夜间控尿良好，排尿习惯无异常。通过在球部尿道周围使用AMS 800人工括约肌，另外2例患者的夜间尿失禁问题得到进一步解决。去管化乙状结肠是膀胱前列腺切除术后一种出色的新膀胱构型。
