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Long-term evaluation of modified orthotopic Y-shaped ileal neobladder (Tanta pouch) with left retro-colic chimney

  • Urology - Original Paper
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Abstract

Purpose

In the present study, we evaluated the long-term results of modified Y-shaped orthotopic ileal neobladder (Tanta pouch) with trans-mesenteric left retro-colic chimney.

Patients and methods

A total of 70 patients with invasive bladder cancer underwent radical cystectomy and modified Y-shaped orthotopic ileal neobladder. (The left chimney elongated to pass to the left side through a window in the mesentery of the pelvic colon and the ureters were implanted directly end to side, in both chimneys after doing good spatulation.

Results

The mean follow-up period ranged between 7 and 10 years (mean 7.8 years). 18 patients died during the period of follow-up. 6 months postoperatively, there was a spherical orientation of the pouch (The mean capacity was 542 ± 47 cm3) and the maximum intra-pouch pressure was 24 ± 3.2 cm H2O. Daytime continence was achieved in 93% of the patients and nighttime continence was achieved in 87%. Stress incontinence occurred in 15% and total incontinence in 2%. Renal function was stable in 93% of renal units. Stricture ureter was not recorded of any case. Of 14 renal units with preoperative dilated ureters, 5 units had improved postoperatively and the others had persistent reflux. 13 renal units (3 unilateral and 5 bilateral) with normal preoperative ureters had persistent postoperative reflux. Persistent reflux showed no influence on renal function.

Conclusion

Modified Y-shaper pouch is suitable for short, dilated ureters. Longitudinal orientation of the pouch facilitates ileo-urethral anastomosis, especially with short mesentery. Long-term follow-up for direct uretero-ileal anastomosis did not show deterioration of the renal function.

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References

  1. Chang DTS, Lawrentschuk N (2015) Orthotopic neobladder reconstruction. Urol Ann 7(1):1–7

    Article  PubMed  PubMed Central  Google Scholar 

  2. Fedewa SA, Soliman A, Ismail K et al (2009) Incidence analyses of bladder cancer in the Nile delta region of Egypt. Canep 3–4:176–181

    Google Scholar 

  3. El-Mateet MS, Emran M, El-Abd S, Mahruky A (1988) Tanta pouch a double barrel ileo-uretero-cystoplasty: a new continent ileal reservoir. J Urol 139:242A (abstract 317)

    Google Scholar 

  4. Hautmann RE, Abo-Elanin H, Daviddsson T et al (2013) ICUD-EAU international consultation on bladder cancer 2012: urinary diversion. Eur Urol 63:67–80

    Article  PubMed  Google Scholar 

  5. Litwin MS, Hays RD, Fink A, Ganz PA, Leake B, Brook RH (1998) The UCLA Prostate Cancer Index: development, reliability, and validity of a health-related quality of life measure. Med Care 36:1002–1012. https://doi.org/10.1097/00005650-199807000-00007

    Article  PubMed  CAS  Google Scholar 

  6. Studer UE, Burkhard FC, Schumacher et al (2006) Twenty years experience with an ileal orthotopic low pressure bladder substitute-lessons to be learned. J Urol 176:161–166

    Article  PubMed  Google Scholar 

  7. Katkoori D, Samavedi S, Adyiat ET et al (2010) Is the incidence of ureteral intestinal anastomoses stricture increased in patients undergoing radical cystectomy with previous pelvic radiation? BJU Int 105:795–798

    Article  PubMed  Google Scholar 

  8. Anderson CB, Morgan TM, Kappa S et al (2013) Uretero-enteric anastomotic stricture after radical cystectomy—does operative approach matter? J Urol 189:541–547

    Article  PubMed  Google Scholar 

  9. Hautmann RF, de Petrioconi RC, Volkmer BG et al (2011) 25 years of experience with 1000 neobladder long-term complications. J Urol 185:2207–2212

    Article  PubMed  Google Scholar 

  10. Elmatteet MS, Omran MA, El Abd S et al (1992) Antireflux procedures applied in the Y-shaped neobladder (Tanta pouch) and its modification J-shaped pouch. J Urol 147:391A (Abstract 714)

    Google Scholar 

  11. Elbendary M, Elgamal OM, Tawfik MT et al (2014) Simple modification in Hautmann neobladder to carry out left uretero-ileal anastomoses without mobilization of the ureter. Int J Urol 21:413–415

    Article  PubMed  Google Scholar 

  12. Msezane L, Reynolds WS, Mhabsekar R et al (2008) Open surgical repair of ureteral stricture and fistulas following radical cystectomy and urinary diversion. J Urol 179:1428–1431

    Article  PubMed  Google Scholar 

  13. Tai R, Sivan B, Kedar D et al (2007) Management of benign ureteral strictures following radical cystectomy and urinary diversion for bladder cancer. J Urol 178:538–542

    Article  Google Scholar 

  14. Shaban AA, Abdel-Latif M, Mosbah A et al (2006) A randomized study comparing an antireflux system with direct ureteral anastomosis in patients with orthotopic ileal neobladder. BJU Int 97:1057–1062

    Article  Google Scholar 

  15. Hollowell CM, Christiano AB, Steinberg GD et al (2000) Technique of Hautmann neobladder with chimney modification interim results in 50 patients. J Urol 163:47–50

    Article  PubMed  CAS  Google Scholar 

  16. Theony HC, Sonnenschein MJ, Madersbacher S et al (2002) Is ileal orthotopic bladder substitution with an afferent tubular segment detrimental to the upper urinary tract in long term? J Urol 168:2030–2034

    Article  Google Scholar 

  17. Yossepowitsh O, Dalabagni Ggolijanin D et al (2003) Orthotopic urinary diversion after cystectomy for bladder cancer implication for cancer control and patterns of disease recurrence. J Urol 169:177–181

    Article  Google Scholar 

  18. Balluhey Q, Thoulouzan M, Lunardi P et al (2012) Prospective study of the results of ureteral intestinal anastomoses in 100 patients after Hautmann neobladder with double chimney Prog. Prog Urol 2:255–260

    Article  Google Scholar 

  19. Fumio I, Ken K, Koh S et al (2013) Peristomal pagetoid spread of urothelial carcinoma of the ureter. Rare Tumors. https://doi.org/10.4081/rt.2013e49

    Article  Google Scholar 

  20. Ayman AH, Samir E, Magdy S et al (2007) Evaluation of direct versus nonrefluxing technique and functional results in orthotopic Y-ileal neobladder after 12 years of follow up. Int J Urol 14(94):300–304

    Google Scholar 

  21. Fontana D, Bellina M, Fasolis G et al (2004) Y-neo-bladder, fast and reliable procedure. Urology 63:699–703

    Article  PubMed  CAS  Google Scholar 

  22. De Thomas S, Murat A, Maarten A et al (2016) The N-shaped orthotopic ileal neobladder: functional outcomes and complication rates in 119 patients. Springerplus. https://doi.org/10.1186/s40064-016-2287-1

    Article  PubMed  PubMed Central  Google Scholar 

  23. Zhong H, Shen Y, Yao Z et al (2019) Long-term outcome of spiral ileal neobladder with orthotopic ureteral reimplantation. Int Urol Nephrol. https://doi.org/10.1007/s11255-019-02296-x

    Article  PubMed  PubMed Central  Google Scholar 

  24. Song S, Kim SC, Park J et al (2011) Renal function change after refluxing type orthotopic ileal substitution. J Urol 186(5):948–952

    Article  Google Scholar 

  25. Lee YS, Jung HB, Choi DK et al (2016) Functional assessment of the Hautmann ileal neobladder with chimney modification using uroflowmetry a nd questionnaire. Biomed Res Int. https://doi.org/10.1155/2016/8209589

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Tanta University, Faculty of Medicine, Tanta, Gharbia, Egypt

    Ayman A. Hassan, Mohamed Elbendary, Mohamed Radwan, Mohamed O. Abo-farha, Tarek Gamil & Mahmoud S. Elmateet

  2. October 6 University, Faculty of Medicine, Giza, Egypt

    Sherif Salah Azab

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  1. Ayman A. Hassan
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  2. Mohamed Elbendary
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  3. Mohamed Radwan
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  4. Mohamed O. Abo-farha
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  5. Tarek Gamil
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  6. Sherif Salah Azab
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  7. Mahmoud S. Elmateet
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Correspondence to Ayman A. Hassan.

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Hassan, A.A., Elbendary, M., Radwan, M. et al. Long-term evaluation of modified orthotopic Y-shaped ileal neobladder (Tanta pouch) with left retro-colic chimney. Int Urol Nephrol 52, 681–686 (2020). https://doi.org/10.1007/s11255-019-02345-5

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