Shimogaki H, Okada H, Fujisawa M, Arakawa S, Kawabata G, Kamidono S, Yamanaka N
Department of Urology, Shinko Hospital and Kobe University School of Medicine, Japan.
J Urol. 1999 Feb;161(2):573-7.
We investigated the long-term outcome of orthotopic neobladders in women.
At our institutions 8 women have undergone lower urinary tract reconstruction with an orthotopic neobladder and have been followed for more than 4 years. After urethral sparing cystectomy the neobladder was constructed and connected to the native urethra. Late complications were analyzed, and voiding function was evaluated by a pressure flow micturition study and bead-chain cystourethrography.
No late complications related to the surgery were noted. Of the 8 patients 7 were completely dry day and night. Four patients with ileal neobladder required clean intermittent catheterization, and hypercontinence might have been caused by downward migration of the neobladder and reduced neobladder pressure at voiding. No recurrence in the native urethra was noted, and all patients were satisfied postoperatively.
These results of orthotopic neobladder in women are encouraging. Overall patient satisfaction was excellent. An international collaborative study is necessary to achieve the number of patients required to determine the ideal orthotopic neobladder for women.
我们研究了女性原位新膀胱的长期疗效。
在我们的机构中，8名女性接受了原位新膀胱下尿路重建手术，并进行了超过4年的随访。在保留尿道的膀胱切除术后，构建新膀胱并将其与天然尿道相连。分析晚期并发症，并通过压力流排尿研究和珠链膀胱尿道造影评估排尿功能。
未发现与手术相关的晚期并发症。8例患者中7例日夜完全无尿失禁。4例回肠新膀胱患者需要清洁间歇性导尿，尿失禁可能是由于新膀胱向下移位和排尿时新膀胱压力降低所致。未发现天然尿道复发，所有患者术后均满意。
女性原位新膀胱的这些结果令人鼓舞。总体患者满意度极佳。有必要开展一项国际合作研究，以获得确定女性理想原位新膀胱所需的患者数量。
