Studer U E, Casanova G A, Mottaz A E, Zingg E J
Clinique Urologique, Inselspital, Berne.
Acta Urol Belg. 1991;59(2):265-82.
An internal urinary diversion after radical cystoprostatectomy has been performed in 70 male patients. The bladder substitute was made from an ileal segment, opened along its antimesenteric border and folded twice, according to Goodwin's "cup-patch technique". After an observation time of 6 months to 6 years, the results are in general good: The initial capacity of the pouch made from only 40 cm of ileum (in order to avoid metabolic disturbances) increases to a functional capacity of 500 ml within the first postoperative weeks. The increase of the bladder substitute's capacity is parallel to the improvement of urinary continence. In general, the latter is achieved after 1-3 months during the day, and after 3-6 months during the night. However, loss of a few drops of urine may occur, reason why half of our patients wear a safety pad later than 6 months after surgery, at least during the night. There was no significant difference between those patients with an antireflux nipple and those patients having an ileal tubular afferent segment.
70例男性患者在根治性膀胱前列腺切除术后进行了体内尿流改道。膀胱替代物由一段回肠制成，根据古德温的“杯状补片技术”，沿其系膜对侧缘打开并折叠两次。经过6个月至6年的观察期，结果总体良好：仅由40厘米回肠制成的贮尿囊（为避免代谢紊乱）的初始容量在术后第一周内增加到500毫升的功能容量。膀胱替代物容量的增加与尿失禁的改善同步。一般来说，白天在1至3个月后实现尿失禁，夜间在3至6个月后实现。然而，可能会出现几滴尿液漏出的情况，这就是我们一半的患者在术后6个月后至少在夜间仍佩戴安全护垫的原因。有抗反流乳头的患者与有回肠管状传入段的患者之间没有显著差异。
