Urodynamic Analysis Of "W" Shape Orthotopic Ileal Neobladder Following Radical Cystectomy

Objective: To evaluate the urodynamic characteristics of “W” shape orthotopic ilealneobladder from the standpoint of urodynamics and to provide urodynamic parameters ofthe ileal neobladders. Methods: Urodynamic studies were carried out in21patients(20males and1females) after radical cycestomy and W shape ileal neobladders by reason ofthe bladder cancer, the mean age was58.7years old(range20to75years old), the medianfollow-up was22months(range9to42months). Urodynamic studies include Qmax, PVR,MCC, compliance, filling phase and voiding phase cystometric pressure etc. Results: Ofthe21patients,14patients(66.7%)had complete all day continence,17patients(81.0%)hadcomplete daytime continence,4patients(19.0%)suffered from incompletely incontinence.Urodynamic studies showed: Qmaxwas5.4～28.9mL/s, average was14.56mL/s; PVRwas0～220mL, average was71mL; MCC was166～610mL, average was362.67mL;filling phase and voiding phase cystometric pressure were18～48cmH2O and34～132cmH2O, average were28.10cmH2O and68.90cmH2O respectively;compliance was13.9～36.7mL/cmH2O.average was23.03mL/cmH2O. The urine flow curve showedcontinual type in12cases and intermittent type in9cases, with mean Qmaxof18.66mL/sand9.09mL/s, mean PVR of29.33mL and128.44mL, mean filling phase cystometricpressure of24.42cmH2O and33.00cmH2O, mean compliance of27.99mL/cmH2O and16.41mL/cmH2O respectively, in the two type groups. These values were significantlydifferent between the two groups(P＜0.01). Conclusion: Orthotopic “W” shape ilealneobladder has an adequate capacity, met the needs of hypobaric storing urine andorthotopic urination, together with favourable compliance, it might be considered as anideal modus operandi of urinary diversion.