Sigmoid orthotopic neobladder after radical cystectomy for bladder tumour: an Indian experience

Abstract

Objective: To determine the long-term results of constructing a sigmoid neobladder after radical cystectomy for transitional cell carcinoma (TCC) of the urinary bladder.

Patients and methods: The study included 170 patients with TCC of the bladder and a normal sigmoid colon. After radical cystectomy the neobladder was formed by completely detubularizing an isolated sigmoid colon segment. Subsequently patients were followed by clinical, biochemical, radiological and urodynamic assessments.

Results: Four patients died soon after surgery; the neobladder-related delayed complications were death in three patients, loss of five renal units, and electrolyte imbalance in five patients. Uretero-intestinal anastomotic narrowing was another frequent delayed complication. Most (97%) patients had nocturnal incontinence, and most voided with a good stream with a minimal postvoid residual urine volume.

Conclusion: The sigmoid neobladder, despite some limitations, is the best option for diverting urine after radical cystectomy.