[Is orthotopic ileal neobladder an acceptable form of urinary diversion from the viewpoint of the patient?].

In 19 patients with bladder cancer who required cystectomy, an orthotopic ileal bladder was created. The patients were followed up for an average of 36 months (12-60 months). In this study we present the early and late postoperative complications, the survival data, quality of life assessment, data from urodynamic investigations, metabolic changes and the situation in the upper tracts. Postoperative complications requiring reoperation occurred in 11% in the early postoperative and in 27.7% in the late postoperative phase. Two of 19 patients died from cancer 18 and 26 months after cystectomy. A further patient had an urethral recurrence and the cancer is progressing further. Questionnaires showed that 80% of our patients were satisfied with their new bladder. Eighty percent were continent during the day and at night. Stress incontinence (II-III) occurred in only 2 patients (12%). All patients were impotent, but in 5 SCAT therapy made intercourse possible. The metabolic acidosis required oral alkalization in 60%. Dilatation of the upper urinary tract was seen in 6% of the renal units. We conclude from our experience that an orthotopic ileal neobladder is an excellent method of urinary diversion after cystectomy.