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Functional results after orthotopic bladder substitution: A prospective multicentre study comparing four types of neobladder

Paananen, Ilkka; Ohtonen, Pasi; Perttila, Ilkka; Jonsson, Olof; Edlund, Christer; Wiklund, Peter; Ljungberg, Borje; Moller-Jensen, Klaus; Jonsson, Eirikur and Månsson, Wiking LU (2014) In Scandinavian Journal of Urology2013-01-01+01:00 48(1). p.90-98
Abstract
Objective. The aim of this study was to evaluate enterocystometry, voiding pattern and urine leakage of four types of orthotopic bladder substitute. Material and methods. At eight urological departments, 78 consecutive men were studied: 66 with an ileal neobladder [30 Studer pouches (S), 24 Hautmann pouches (H) and 12 T-pouches (T)] and 12 with a right colonic [Goldwasser type (G)] neobladder. Enterocystometry, determination of residual urine, micturition protocol and 24 h pad weight test were performed 6 and 12 months postoperatively. Results. Colonic neobladders had higher pouch pressure at first desire, normal desire and strong desire than ileal neobladders (except at first and normal desire at 12 months) (p < 0.02) and contraction... (More)
Objective. The aim of this study was to evaluate enterocystometry, voiding pattern and urine leakage of four types of orthotopic bladder substitute. Material and methods. At eight urological departments, 78 consecutive men were studied: 66 with an ileal neobladder [30 Studer pouches (S), 24 Hautmann pouches (H) and 12 T-pouches (T)] and 12 with a right colonic [Goldwasser type (G)] neobladder. Enterocystometry, determination of residual urine, micturition protocol and 24 h pad weight test were performed 6 and 12 months postoperatively. Results. Colonic neobladders had higher pouch pressure at first desire, normal desire and strong desire than ileal neobladders (except at first and normal desire at 12 months) (p < 0.02) and contraction was present more often at both 6 and 12 months (p < 0.01 and p < 0.01). Compliance was good in all types of pouch. Intermittent self-catheterization was more common in H patients at 6 months (p = 0.033). All patients with colonic neobladders used pads during the day and night. In patients with ileal pouches 32% used pads during the day and 70% during the night at 12 months. Urine leakage was higher in patients with colonic bladders at 6 and 12 months during the day (mean/median of 98/31 ml and 82/16 ml versus 10/0 ml and 4/0 ml, p < 0.001). T-pouches had excellent day-time continence, but nocturnal leakage was high. Conclusions. The Hautmann pouch and the Studer pouch behaved similarly at enterocystometry and clinically, and continence was good in the majority of patients. The low number of patients with the other two types of pouch precludes definitive statements. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
bladder cancer, cystectomy, enterocystometry, micturition protocol, orthotopic neobladder, pad weight test
in
Scandinavian Journal of Urology2013-01-01+01:00
volume
48
issue
1
pages
90 - 98
publisher
Taylor & Francis
external identifiers
  • wos:000332420100013
  • scopus:84895425861
ISSN
2168-1813
DOI
10.3109/21681805.2013.799225
language
English
LU publication?
yes
id
033b50e1-0cb4-452b-b6c8-d31a29fa2673 (old id 4418941)
date added to LUP
2014-05-05 07:21:42
date last changed
2017-02-22 11:43:57
@article{033b50e1-0cb4-452b-b6c8-d31a29fa2673,
  abstract     = {Objective. The aim of this study was to evaluate enterocystometry, voiding pattern and urine leakage of four types of orthotopic bladder substitute. Material and methods. At eight urological departments, 78 consecutive men were studied: 66 with an ileal neobladder [30 Studer pouches (S), 24 Hautmann pouches (H) and 12 T-pouches (T)] and 12 with a right colonic [Goldwasser type (G)] neobladder. Enterocystometry, determination of residual urine, micturition protocol and 24 h pad weight test were performed 6 and 12 months postoperatively. Results. Colonic neobladders had higher pouch pressure at first desire, normal desire and strong desire than ileal neobladders (except at first and normal desire at 12 months) (p &lt; 0.02) and contraction was present more often at both 6 and 12 months (p &lt; 0.01 and p &lt; 0.01). Compliance was good in all types of pouch. Intermittent self-catheterization was more common in H patients at 6 months (p = 0.033). All patients with colonic neobladders used pads during the day and night. In patients with ileal pouches 32% used pads during the day and 70% during the night at 12 months. Urine leakage was higher in patients with colonic bladders at 6 and 12 months during the day (mean/median of 98/31 ml and 82/16 ml versus 10/0 ml and 4/0 ml, p &lt; 0.001). T-pouches had excellent day-time continence, but nocturnal leakage was high. Conclusions. The Hautmann pouch and the Studer pouch behaved similarly at enterocystometry and clinically, and continence was good in the majority of patients. The low number of patients with the other two types of pouch precludes definitive statements.},
  author       = {Paananen, Ilkka and Ohtonen, Pasi and Perttila, Ilkka and Jonsson, Olof and Edlund, Christer and Wiklund, Peter and Ljungberg, Borje and Moller-Jensen, Klaus and Jonsson, Eirikur and Månsson, Wiking},
  issn         = {2168-1813},
  keyword      = {bladder cancer,cystectomy,enterocystometry,micturition protocol,orthotopic neobladder,pad weight test},
  language     = {eng},
  number       = {1},
  pages        = {90--98},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Journal of Urology2013-01-01+01:00},
  title        = {Functional results after orthotopic bladder substitution: A prospective multicentre study comparing four types of neobladder},
  url          = {http://dx.doi.org/10.3109/21681805.2013.799225},
  volume       = {48},
  year         = {2014},
}