Early Experiences with Studer’s Orthotopic Neobladder (original) (raw)

Studer Orthotopic Neobladder: a Modified Surgical Technique

Urology, 2015

OBJECTIVE A modified technique for orthotopic ileal neobladder preparation is described. The Studer technique is the method most frequently used worldwide and seems to be an ideal reconstructive solution after radical cystectomy. METHODS After radical cystectomy, urinary diversion is attained by means of a detubulized ileal segment. About 40 cm are used to create the reservoir and 15 cm for a tubular afferent limb. A spheroidal-shaped reservoir is then obtained with a conic distal part that will be anastomized to the urethral stump. After the reconstructive part, the neobladder and the afferent limb are attached to the levator ani and psoas muscles respectively. Post-operative results on a series of 36 patients are reported. RESULTS The final shape of the reservoir was roughly spherical. A small amount of anastomotic strictures was registered. Renal function was not impaired after surgery, even at late follow-up. CONCLUSION Even if the Studer technique is already well described, we believe that our technical changes may improve urinary tract restoration, and potentially decrease complications typical of urinary orthotopic diversion. Further cases are required to confirm possible advantages of the modified technique.

Orthotopic neobladder: A 22-year experience

Acta chirurgica iugoslavica, 2007

Objective: To analyze the outcome of orthotopic ileal neobladder related to complications and quality of life. Patients and methods: From 1985 to 2006, 75 patients with mean age of 57 years, (41-75) underwent radical cystectomy and orthotopic ileal neobladder substitution. The mean follow up was 72 months (6-144). Mean operative time was 240 minutes. Results: Intraoperative blood loss ranged from 250 to 2810 ml. Ureteral stents were removed on 14th postoperative day, and patients were discharged at 21st day, average. Complications appeared in 23 patients. There were two recurrent TCC in the neobladder. Three patients died from pulmonary embolism. Vesicoureteral reflux appeared in three patients, and it was bilateral in two patients. Total of 98% patients have daytime continence. Conclusion: Continent urinary reservoirs represent the state of the art in urinary diversion. Surgeons who perform these operations are urgent to institute requirements for careful long-term follow-up of the...

Orthotopic neobladder reconstruction - what are the options?

BJU International, 2005

... 10 Meyer JP, Drake B, Boorer J, Gillatt D, Persad R, Fawcett D. A three-centre experience of orthotopic neobladder reconstruction after radical cystectomy: initial results. BJU ... 15 Bochner BH, Figueroa AJ, Skinner DG et al. Salvage ...

Endoscopic Treatment of Studer's Orthotopic Neobladder Lithiasis

Urology Case Reports, 2015

Studer's neobladder lithiasis is a rare but important long term complication of this orthotopic bladder substitute technique. We report a case of a 45 year-old male patient, submitted to a radical cystoprostatectomy with a Studer's orthotopic neobladder 4 years before, presenting bad compliance to recommended urinary habits, increased production of mucus and high post voiding residue. CT scan and urethrocystography showed a distended pouch with 2 major sacculations with narrow communication and a stone in each sacculation. A minimally invasive endoscopic technique was successfully used in the treatment of the 2 small calculus.

Orthotopic neobladder reconstruction

Urology annals

Orthotopic neobladder reconstruction is becoming an increasingly common urinary diversion following cystectomy for bladder cancer. This is in recognition of the potential benefits of neobladder surgery over creation of an ileal conduit related to quality of life (QoL), such as avoiding the need to form a stoma with its cosmetic, psychological and other potential complications. The PubMed database was searched using relevant search terms for articles published electronically between January 1994 and April 2014. Full-text articles in English or with English translation were assessed for relevance to the topic before being included in the review. Patients with neobladders have comparable or better post-operative sexual function than those with ileal conduits. They also have comparable QoL to those with ileal conduits. Orthotopic neobladder is a good alternative to ileal conduit in suitable patients who do not want a stoma and are motivated to comply with neobladder training. However, t...

Long-term Functional Outcome and Late Complications of Studer's Ileal Neobladder

Japanese Journal of Clinical Oncology, 2005

The purpose of this study was to evaluate the long-term functional outcome and late complications of Studer's ileal neobladder. Methods: The study included 57 patients who underwent radical cystectomy and bladder reconstruction with Studer's ileal neobladder, and were followed-up for at least 3 months after surgery. The voiding and storage function, and late complications were evaluated. The times of evaluation after surgery were categorized into periods I (3-23 months), II (24-59 months), III (60-95 months) and IV (>96 months). Results: Daytime and night-time continence rates were 95.6 and 88.6%, respectively. The averages of functional capacity (439 ml), maximum flow rate (15.7 ml/s) and residual urine (35 ml) evaluated in period I were maintained in period IV. Of the 57 patients, intermittent selfcatheterization was needed in five (8.8%) due to incomplete emptying or urinary retention. Urethroileal anastomotic stricture was found in two patients (3.5%), who were successfully treated by transurethral intervention. Inguinal hernia was found in seven patients (12.8%), five of whom developed it within 2 years after surgery. Conclusions: Our results indicate that Studer's ileal neobladder had a favorable long-term functional outcome. Although late complication rates were low, the incidence of inguinal hernia was relatively high, and this was considered as a definite late complication in our study.

Short ileal segment for orthotopic neobladder: A feasibility study

… journal of urology, 2010

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) ...