Neobladder Using Ileum, Cecum And Ascending Colon

Purpose: To estimate the clinical results of neobladder using detenial ileum, cecum and ascending colon .Method : 5 cases of bladder cancer were treated by radical cyste -ctomy and the construction of neobladder using detenial ileum, cecum and ascending colon. After cystectomy ,10cm of distal ileum and 15cm of ascending colon were used to construct neobladder ,the proximal ileum was then anastomosed to the distal colon.5 cm of ileum near cecum was folded along its long axis to form the anti-reflax segment, both ureters were anastomosed to the proximal part of the ileum segment .The urine reservoir was constructed by the detenial cecum and ascending colon , a small hole was made at the lowest part of the urine reservoir to be anastomosed to the urethra . The continence , urine dynamics , serum electrolytes, renal function and life quality have been followed up .Results : All the 5 cases have been followed up for 12 to 18 months , urethral recerrence was observed in only 1 case .1 :Continence and urine dynamicsThe daytime continence rate was 100%,and the nighttime continencerate was 80% in 6 months after operation. The urine dynamics examination of the five patients from 6 to ] 8 months showed the averagecapacity of the neobladder had been 380ml, the average intrareservoir pressure 2.82kpa, the average maximum urine flow rate 18ml/s ,the average voiding volumn 280ml per time (100-404ml per time) and the average residual volumn 24.8ml (0-48ml)2 urography and renal functionAt least one time of IVU has been done in all 5 cases .The development of both kidneys was normal without hydronephrosis . Slight expansion of ureter was observed in 2 cases. Reflux of bladder was not observed .There was no remarkable changes in level of BUN> Cr before and after operation.3 Urine culture has been done periodically. Positive result was observed in 1 case ,but no signs of urinary infection were found .4 ComplicationsMai healing of wound was observed in 1 case , but the wound finally healed after changing dressings. No other complications were observed .Conclusion: Due to its good continence and low complication, neobladder using ileum cecum and ascending colon is an ideal method of urinary diversion .