Othotopic ileal neobladder “Belgrade pouch” in females
Background/Aim. Orthotopic continent neobladder pro-vides adequate capacity, low pressure reservoir, acceptable rate of continence and satisfactory voiding frequency. Standard surgical techniques require the usage of an ileal segment in the length of 50–65 cm for neobladder creation with favorable r...
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Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade
2022-01-01
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| Series: | Vojnosanitetski Pregled |
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| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2022/0042-84502000052A.pdf |
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| author | Aleksić Predrag Bančević Vladimir |
| author_facet | Aleksić Predrag Bančević Vladimir |
| author_sort | Aleksić Predrag |
| collection | DOAJ |
| description | Background/Aim. Orthotopic continent neobladder pro-vides adequate capacity, low pressure reservoir, acceptable rate of continence and satisfactory voiding frequency. Standard surgical techniques require the usage of an ileal segment in the length of 50–65 cm for neobladder creation with favorable results. However, the usage of a long intestinal segment is associated with high neobladder capacity, voiding problems, and metabolic complications. The aim of this study was to analyze clinical outcomes of the “Belgrade pouch” orthotopic bladder replacement in female patients and to promote the usage of shorter ileal segment for neobladder creation. Methods. A prospective study conducted in our institution from 2009 to 2019 included 37 female patients who underwent orthotopic bladder replacement ac-cording to “Belgrade pouch” technique with the usage of shorter ileal segment whose average length for neobladder creation was 28 cm. Inclusion criteria were: female continent patients older than 18, organ-confined muscle-invasive bladder carcinoma and, the American Society of Anestesiologists (ASA) score 1 or 2. Exclusion criteria were: diabetes mellitus, obstructive pulmonary diseases, systemic illnesses and metabolic diseases which may have some influence on results interpretation, renal deterioration and preoperative incontinence. We analyzed operative time, blood loss, histopathological findings, continence rate, metabolic disorders, immediate and delayed complications and survival rate in two-year periods of follow-up. Results. Average age of patients was 58 (32–67) years. Average time of surgical procedures was 199 (155–320) min. Blood transfusion was intraoperatively applied in 32.43% of the patients in average volume of 385 (300–640) mL. A total of 29.47% patients had anemia preoperatively. In the early postoperative period we reported one patient with paralytic ileus which was resolved conservatively and one patient with urinary fistula appearance; 56.75% of the patients were in pT2 stage. Two years following the surgery, day-time continence was achieved in 91.89% of the patients, neobladder capacity was 459 (345–592 ) mL, post-void residual urine volume was 27 (0–40) mL, 24 h voiding frequency 6, metabolic acidosis appeared in 2.7% of the patients. Survival rate in 2-year period was 86.48%. Conclusion. Orthotropic ileal neobladder created from the shorter ileal segment (“Belgrade pouch”) in females provides a high level of continence without a significant increase of voiding frequency, with adequate capacity, without urinary tract retention and with decrease of metabolic complications. |
| format | Article |
| id | doaj-art-29cf89c2933443db8acbc9f6dc8e554b |
| institution | DOAJ |
| issn | 0042-8450 2406-0720 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade |
| record_format | Article |
| series | Vojnosanitetski Pregled |
| spelling | doaj-art-29cf89c2933443db8acbc9f6dc8e554b2025-08-20T03:17:42ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202022-01-01791758010.2298/VSP200416052A0042-84502000052AOthotopic ileal neobladder “Belgrade pouch” in femalesAleksić Predrag0Bančević Vladimir1https://orcid.org/0000-0003-0406-9008Military Medical Academy, Urology Clinic, Belgrade, Serbia + University of Defence, Faculty of Medicine of Military Medical Academy, Belgrade, SerbiaMilitary Medical Academy, Urology Clinic, Belgrade, Serbia + University of Defence, Faculty of Medicine of Military Medical Academy, Belgrade, SerbiaBackground/Aim. Orthotopic continent neobladder pro-vides adequate capacity, low pressure reservoir, acceptable rate of continence and satisfactory voiding frequency. Standard surgical techniques require the usage of an ileal segment in the length of 50–65 cm for neobladder creation with favorable results. However, the usage of a long intestinal segment is associated with high neobladder capacity, voiding problems, and metabolic complications. The aim of this study was to analyze clinical outcomes of the “Belgrade pouch” orthotopic bladder replacement in female patients and to promote the usage of shorter ileal segment for neobladder creation. Methods. A prospective study conducted in our institution from 2009 to 2019 included 37 female patients who underwent orthotopic bladder replacement ac-cording to “Belgrade pouch” technique with the usage of shorter ileal segment whose average length for neobladder creation was 28 cm. Inclusion criteria were: female continent patients older than 18, organ-confined muscle-invasive bladder carcinoma and, the American Society of Anestesiologists (ASA) score 1 or 2. Exclusion criteria were: diabetes mellitus, obstructive pulmonary diseases, systemic illnesses and metabolic diseases which may have some influence on results interpretation, renal deterioration and preoperative incontinence. We analyzed operative time, blood loss, histopathological findings, continence rate, metabolic disorders, immediate and delayed complications and survival rate in two-year periods of follow-up. Results. Average age of patients was 58 (32–67) years. Average time of surgical procedures was 199 (155–320) min. Blood transfusion was intraoperatively applied in 32.43% of the patients in average volume of 385 (300–640) mL. A total of 29.47% patients had anemia preoperatively. In the early postoperative period we reported one patient with paralytic ileus which was resolved conservatively and one patient with urinary fistula appearance; 56.75% of the patients were in pT2 stage. Two years following the surgery, day-time continence was achieved in 91.89% of the patients, neobladder capacity was 459 (345–592 ) mL, post-void residual urine volume was 27 (0–40) mL, 24 h voiding frequency 6, metabolic acidosis appeared in 2.7% of the patients. Survival rate in 2-year period was 86.48%. Conclusion. Orthotropic ileal neobladder created from the shorter ileal segment (“Belgrade pouch”) in females provides a high level of continence without a significant increase of voiding frequency, with adequate capacity, without urinary tract retention and with decrease of metabolic complications.http://www.doiserbia.nb.rs/img/doi/0042-8450/2022/0042-84502000052A.pdfcolonic pouchesfemalepostoperative complicationsserbiatreatment outcomeurinary bladder neoplasmsurological surgical procedures |
| spellingShingle | Aleksić Predrag Bančević Vladimir Othotopic ileal neobladder “Belgrade pouch” in females Vojnosanitetski Pregled colonic pouches female postoperative complications serbia treatment outcome urinary bladder neoplasms urological surgical procedures |
| title | Othotopic ileal neobladder “Belgrade pouch” in females |
| title_full | Othotopic ileal neobladder “Belgrade pouch” in females |
| title_fullStr | Othotopic ileal neobladder “Belgrade pouch” in females |
| title_full_unstemmed | Othotopic ileal neobladder “Belgrade pouch” in females |
| title_short | Othotopic ileal neobladder “Belgrade pouch” in females |
| title_sort | othotopic ileal neobladder belgrade pouch in females |
| topic | colonic pouches female postoperative complications serbia treatment outcome urinary bladder neoplasms urological surgical procedures |
| url | http://www.doiserbia.nb.rs/img/doi/0042-8450/2022/0042-84502000052A.pdf |
| work_keys_str_mv | AT aleksicpredrag othotopicilealneobladderbelgradepouchinfemales AT bancevicvladimir othotopicilealneobladderbelgradepouchinfemales |