World Journal of Urology

, Volume 30, Issue 6, pp 747–752

Perugia ileal neobladder: functional results and complications

  • Massimo Porena
  • Luigi Mearini
  • Alessandro Zucchi
  • Michele Del Zingaro
  • Ettore Mearini
  • Antonella Giannantoni
Original Article

DOI: 10.1007/s00345-012-0985-z

Cite this article as:
Porena, M., Mearini, L., Zucchi, A. et al. World J Urol (2012) 30: 747. doi:10.1007/s00345-012-0985-z

Abstract

Purpose

To evaluate the long-term functional results and complications of an orthotopic ileal neobladder, defined as perugia ileal neobladder (PIN), in a group of patients with bladder cancer who underwent radical cystectomy (RC).

Methods

Between 1993 and 2009, 237 consecutive patients who underwent RC for non-metastatic bladder cancer and orthotopic ileal neobladder reconstruction were enrolled. The neobladder was created using a modified Camey-II technique and consisted of a detubularized ileal loop of 45 cm using a vertical “Y” shape. Complications (<90 days) were reviewed and staged according to Clavien–Dindo classification and evaluated at long-term follow-up. Standard monitoring for cancer recurrence (computerized tomography, bone scan), cystourethrography, urodynamics and frequency/volume charts were performed during follow-up.

Results

The median follow-up was 64 months, and the 5-year overall survival rate was 64 %. Early complications were mostly grade I and II; grade III and IV complications were observed in 27 patients. Perioperative mortality rate was 1.6 %. The most frequent late complications were neobladder–ureteral reflux, urolithiasis and urethral anastomotic stricture. Daytime and nighttime urinary continence were 93.5 and 83.9 %, respectively. All patients were able to completely empty neobladders. Twenty patients were followed up for at least 10 years and presented satisfactory functional results.

Conclusions

Surgical morbidity of RC and orthotopic neobladder was significant; however, the rate of grade III–IV complications was low. The long-term functional results of the PIN were interesting, confirming that appropriate patients’ selection, adequate surgical technique, accurate patients’ counseling and follow-up are essential.

Keywords

Bladder cancerIleal neobladderFollow-upClavien–DindoContinenceFunctional results

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Massimo Porena
    • 1
  • Luigi Mearini
    • 1
  • Alessandro Zucchi
    • 1
  • Michele Del Zingaro
    • 1
  • Ettore Mearini
    • 1
  • Antonella Giannantoni
    • 1
  1. 1.Urology DepartmentUniversity of PerugiaPerugiaItaly