Cross-sectional survey of voiding habits in male patients undergoing ileal neobladder reconstruction

In patients who have undergone radical cystectomy and neobladder reconstruction, attempts are usually made during long-term follow-up to increase reservoir volume. However, while strict urinary management is recommended to keep good neobladder capacity, there is no consensus about the relationship between the urinary management and neobladder capacity. A cross-sectional survey of the relationship between the state of urinary management and neobladder capacity and residual urine volume was undertaken in 41 of 83 male outpatients who underwent ileal neobladder reconstruction at Kansai Medical University and Kyoto University from April 1993 to April 2005. For urinary management, "daytime voiding at intervals of 5 hrs or longer" was found in 8 patients and "not performing regular interval voiding at night" was seen in 12. Of the 41 patients, 18 (43.9%) had a capacity of 500 ml or more. In those with a neobladder capacity of 500 ml or more, no relationship was found with age, operative procedure or postoperative period. However, "daytime voiding at intervals of 5 hrs or longer" and "not performing regular interval voiding at night" were significantly related with neobladder capacity. As well, in cases with a postoperative period of about 5 years, "a postoperative course of over 5 years" and "a daytime voiding at intervals of 5 hrs or longer" were related to a neobladder capacity of 500 ml or more (p=0.032). From this study, we postulated that "daytime voiding at regular intervals "and "regular interval voiding at night" are important factors for preventing an increase in neobladder capacity.