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Objectives: The objective of this study was to present the construction of a neobladder with a modified pouch technique using 25-35 cm of terminal ileum. Methods: Thirty-eight patients whose pouch was constructed from 25-35 cm of terminal ileum (short pouch [SP] group) were prospectively evaluated vs 41 patients whose pouch was constructed from 50-70 cm of terminal ileum (long pouch group). Pouch volume, post-void residual (PVR) volume, need for catheterization, continence and voiding frequency were evaluated at 3 and 12 months after surgery. Results: SP group patients had significantly smaller pouch capacity (440 vs 840 mL, P < 0.001) at month 12, and smaller PVR at postoperative months 3 (11 [0-43]vs 40 [0-147] mL, P < 0.001) and 12 (10 [0-90]vs 72 [0-570] mL, P < 0.001). SP group patients had significantly higher voiding frequency on postoperative month 3 (10 vs 9, P < 0.001) and 12 (7 vs 6, P < 0.005). Continence was significantly improved in the SP group compared with the long pouch group after 12 months (63.2% vs 34.1%, respectively, P = 0.034). Full continence improved significantly over time (P < 0.001) in the SP group, from 26.3% at month 3 to 63.2% at month 12. Conclusion: A pouch constructed from 25-35 cm of terminal ileum provides adequate capacity, smaller PVR, satisfactory continence and a better 24-h voiding frequency pattern during the first postoperative year.
Urology Clinic, Military Medical Academy, Belgrade, Serbia.
This article was published in the following journal.
Name: International journal of urology : official journal of the Japanese Urological Association
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There are no guidelines for evaluation and management of incontinence in women with orthotopic neobladder. We propose a treatment algorithm based on our experience treating this patient population.
Short Segment Spinal Instrumentation with Index Vertebra Pedicle Screw Placement for Pathologies Involving the Anterior and Middle Vertebral Column is Equally Effective as Long Segment Stabilization with Cage Reconstruction: A Biomechanical Study.
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Objectives and Specific Aims Time efficiency of robot assisted radical cystectomy (RARC) with totally intracorporeal stapled orthotopic neobladder remains a main drawback of this procedure...
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Studies to determine the advantages or disadvantages, practicability, or capability of accomplishing a projected plan, study, or project.
Congenital MEGACOLON resulting from the absence of ganglion cells (aganglionosis) in a distal segment of the LARGE INTESTINE. The aganglionic segment is permanently contracted thus causing dilatation proximal to it. In most cases, the aganglionic segment is within the RECTUM and SIGMOID COLON.
The light sensitive outer portion of a retinal rod or a cone photoreceptor cell. The outer segment contains a stack of disk membranes laden with photoreceptive pigments (RETINAL PIGMENTS). The outer segment is connected to the inner segment by a PHOTORECEPTOR CONNECTING CILIUM.
A segment of the immunoglobulin heavy chains, encoded by the IMMUNOGLOBULIN HEAVY CHAIN GENES in the J segment where, during the maturation of B-LYMPHOCYTES; the gene segment for the variable region upstream is joined to a constant region gene segment downstream. The exact position of joining of the two gene segments is variable and contributes to ANTIBODY DIVERSITY. It is distinguished from the IMMUNOGLOBULIN J CHAINS; a separate polypeptide that serves as a linkage piece in polymeric IGA or IGM.
Pathological development in the ILEUM including the ILEOCECAL VALVE.
Benign Prostatic Hyperplasia (BPH) Erectile Dysfunction Urology Urology is the branch of medicine concerned with the urinary tract and diseases that affect it. Examples include urethritis, urethrostenosis and incontinence. Urology is a su...