Becht E, Alloussi S, Ziegler M
Urologische Klinik und Poliklinik, Universität des Saarlandes, Homburg/Saar.
Urologe A. 1995 May;34(3):243-7.
Ileum neobladder after cystectomy is mainly reserved for male patients. Female patients are normally excluded from this kind of urinary diversion for fear of incontinence following orthotopic bladder substitution. In addition as in the male, the question of urethral recurrence of urothelial carcinoma is still not settled. We report on seven cases of successful orthotopic bladder reconstruction in females by means of an ileum neobladder according to Hautmann with follow up of up to 4.5 years. One of these patients had a complicated bladder-vaginal fistula and almost complete loss of bladder function because of a shrunken bladder after radiation therapy for a cervical carcinoma and the other six had undergone radical cystectomy because of bladder carcinoma. The ileum neobladder is anastomosed with the preserved urethral stump. The original method of ileum neobladder is extended by a colposuspension plasty according to Marshall-Marchetti, which is the means of achieving continence. The first results are encouraging and open further possibilities for bladder reconstruction in the female.
膀胱切除术后的回肠新膀胱主要适用于男性患者。女性患者通常不采用这种尿流改道术，因为担心原位膀胱替代术后会出现尿失禁。此外，与男性情况一样，尿路上皮癌尿道复发的问题仍未解决。我们报告了7例采用Hautmann法通过回肠新膀胱对女性进行原位膀胱重建成功的病例，随访时间长达4.5年。其中1例患者因宫颈癌放疗后膀胱萎缩出现复杂的膀胱阴道瘘且膀胱功能几乎完全丧失，另外6例因膀胱癌接受了根治性膀胱切除术。回肠新膀胱与保留的尿道残端吻合。根据Marshall-Marchetti法，通过阴道悬吊成形术对回肠新膀胱的原始方法进行了扩展，这是实现控尿的手段。初步结果令人鼓舞，为女性膀胱重建开辟了更多可能性。
