Jarolím L, Babjuk M, Hanus T, Janský M, Skrivanová V
Department of Urology, First Medical Faculty, Charles University, General Hospital, Prague, Czech Republic.
Eur Urol. 1997;31(2):173-7. doi: 10.1159/000474445.
Orthotopic bladder replacement after cystoprostatectomy has long become the method of choice in the treatment of infiltrating bladder cancer in males. Very good quality of life in patients thus treated stimulated the work on a similar approach applicable to females.
Twelve females were treated by urethra-sparing cystectomy. The surgical technique preserves not just the urethra itself but also the pelvic floor and relevant innervation.
Diurnal continence was achieved in 11 patients, 1 of whom had a so-called hypercontinence with a residual volume of 300 ml. The remaining patient suffered from stress incontinence.
The described urethra-sparing radical cystectomy in female patients with a urothelial tumor, with normal pelvic floor and with a low risk of secondary affection of the urethra, permits reconstructing a continent orthotopic neobladder from a detubularized intestinal segment.
膀胱前列腺切除术后原位膀胱替代术长期以来一直是男性浸润性膀胱癌治疗的首选方法。接受这种治疗的患者生活质量非常好，这促使人们开展适用于女性的类似治疗方法的研究。
12名女性接受了保留尿道的膀胱切除术。该手术技术不仅保留了尿道本身，还保留了盆底及相关神经支配。
11名患者实现了日间控尿，其中1名患者存在所谓的控尿过度，残余尿量为300毫升。其余1名患者患有压力性尿失禁。
对于患有尿路上皮肿瘤、盆底正常且尿道继发受累风险较低的女性患者，所描述的保留尿道根治性膀胱切除术允许用去管化肠段重建可控性原位新膀胱。
