Uterus-, Fallopian Tube-, Ovary-, and Vagina-sparing Cystectomy Followed by U-shaped Ileal Neobladder Construction for Female Bladder Cancer Patients: Oncological and Functional Outcomes
Objectives To evaluate oncological outcomes and voiding functions after orthotopic neobladder reconstruction with preservation of gynecologic organs in female bladder cancer patients. Methods A total of 30 consecutive female patients who underwent radical cystectomy and U-shaped ileal neobladder (co...
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| Veröffentlicht in: | Urology (Ridgewood, N.J.) N.J.), 2010-06, Vol.75 (6), p.1499-1503 |
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| creator | Koie, Takuya Hatakeyama, Shingo Yoneyama, Takahiro Hashimoto, Yasuhiro Kamimura, Noritaka Ohyama, Chikara |
| description | Objectives To evaluate oncological outcomes and voiding functions after orthotopic neobladder reconstruction with preservation of gynecologic organs in female bladder cancer patients. Methods A total of 30 consecutive female patients who underwent radical cystectomy and U-shaped ileal neobladder (constructed using 40 cm of a double-folded ileal loop) substitution were retrospectively analyzed. Of the 30 patients, 29 had urothelial carcinoma and 1 had leiomyosarcoma. Computed tomography was performed every 6 months. Urethroscopic examination was performed at 3-month intervals during the first and second years, and at 6-month intervals thereafter. Pressure flow studies, including urethral pressure profilometry, were performed 3, 6, 9, and 12 months after surgery. Results During a median follow-up of 35.7 months, 1 patient exhibited local recurrence and 6 patients died of bladder cancer. Maximum neobladder pressure examined 12 months after surgery improved significantly as compared with that examined after 3 months ( P |
| doi_str_mv | 10.1016/j.urology.2009.08.083 |
| format | Article |
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Methods A total of 30 consecutive female patients who underwent radical cystectomy and U-shaped ileal neobladder (constructed using 40 cm of a double-folded ileal loop) substitution were retrospectively analyzed. Of the 30 patients, 29 had urothelial carcinoma and 1 had leiomyosarcoma. Computed tomography was performed every 6 months. Urethroscopic examination was performed at 3-month intervals during the first and second years, and at 6-month intervals thereafter. Pressure flow studies, including urethral pressure profilometry, were performed 3, 6, 9, and 12 months after surgery. Results During a median follow-up of 35.7 months, 1 patient exhibited local recurrence and 6 patients died of bladder cancer. Maximum neobladder pressure examined 12 months after surgery improved significantly as compared with that examined after 3 months ( P <.01). Maximal urethral closure pressure also improved significantly 12 months after surgery as compared with that after 3 months ( P <.05). The capacity of the ileal neobladder 3 months after operation was 204 ± 84 mL, and it showed a gradual increase, reaching 311 ± 95 mL at 12 months ( P <.01). None of the patients required catheterization for residual urine. Twenty-four patients (80%) remained completely dry day and night, voiding once or twice during the night. Conclusions Orthotopic neobladder reconstruction with preservation of gynecologic organs is feasible for female bladder cancer patients. Although the follow-up period was not long, the present technique provided acceptable oncological outcome and voiding function.</description><identifier>ISSN: 0090-4295</identifier><identifier>EISSN: 1527-9995</identifier><identifier>DOI: 10.1016/j.urology.2009.08.083</identifier><identifier>PMID: 19969331</identifier><identifier>CODEN: URGYAZ</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Aged, 80 and over ; Biological and medical sciences ; Carcinoma, Transitional Cell - pathology ; Carcinoma, Transitional Cell - surgery ; Cohort Studies ; Cystectomy - adverse effects ; Cystectomy - methods ; Fallopian Tubes - surgery ; Feasibility Studies ; Female ; Follow-Up Studies ; Genitalia, Female - surgery ; Humans ; Immunohistochemistry ; Medical sciences ; Middle Aged ; Minimally Invasive Surgical Procedures - methods ; Neoplasm Staging ; Nephrology. Urinary tract diseases ; Ovary - surgery ; Postoperative Complications - physiopathology ; Quality of Life ; Reconstructive Surgical Procedures - adverse effects ; Reconstructive Surgical Procedures - methods ; Recovery of Function ; Retrospective Studies ; Risk Assessment ; Treatment Outcome ; Tumors of the urinary system ; Urinary Bladder Neoplasms - pathology ; Urinary Bladder Neoplasms - surgery ; Urinary Reservoirs, Continent ; Urinary system involvement in other diseases. Miscellaneous ; Urinary tract. Prostate gland ; Urination - physiology ; Urodynamics ; Urology</subject><ispartof>Urology (Ridgewood, N.J.), 2010-06, Vol.75 (6), p.1499-1503</ispartof><rights>Elsevier Inc.</rights><rights>2010 Elsevier Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright (c) 2010 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c515t-11aa796716192c275c520cbe8369ea3e3c9fe8f618510c1d1f8abcdac6cc5a753</citedby><cites>FETCH-LOGICAL-c515t-11aa796716192c275c520cbe8369ea3e3c9fe8f618510c1d1f8abcdac6cc5a753</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0090429509027101$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22906965$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19969331$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Koie, Takuya</creatorcontrib><creatorcontrib>Hatakeyama, Shingo</creatorcontrib><creatorcontrib>Yoneyama, Takahiro</creatorcontrib><creatorcontrib>Hashimoto, Yasuhiro</creatorcontrib><creatorcontrib>Kamimura, Noritaka</creatorcontrib><creatorcontrib>Ohyama, Chikara</creatorcontrib><title>Uterus-, Fallopian Tube-, Ovary-, and Vagina-sparing Cystectomy Followed by U-shaped Ileal Neobladder Construction for Female Bladder Cancer Patients: Oncological and Functional Outcomes</title><title>Urology (Ridgewood, N.J.)</title><addtitle>Urology</addtitle><description>Objectives To evaluate oncological outcomes and voiding functions after orthotopic neobladder reconstruction with preservation of gynecologic organs in female bladder cancer patients. Methods A total of 30 consecutive female patients who underwent radical cystectomy and U-shaped ileal neobladder (constructed using 40 cm of a double-folded ileal loop) substitution were retrospectively analyzed. Of the 30 patients, 29 had urothelial carcinoma and 1 had leiomyosarcoma. Computed tomography was performed every 6 months. Urethroscopic examination was performed at 3-month intervals during the first and second years, and at 6-month intervals thereafter. Pressure flow studies, including urethral pressure profilometry, were performed 3, 6, 9, and 12 months after surgery. Results During a median follow-up of 35.7 months, 1 patient exhibited local recurrence and 6 patients died of bladder cancer. Maximum neobladder pressure examined 12 months after surgery improved significantly as compared with that examined after 3 months ( P <.01). Maximal urethral closure pressure also improved significantly 12 months after surgery as compared with that after 3 months ( P <.05). The capacity of the ileal neobladder 3 months after operation was 204 ± 84 mL, and it showed a gradual increase, reaching 311 ± 95 mL at 12 months ( P <.01). None of the patients required catheterization for residual urine. Twenty-four patients (80%) remained completely dry day and night, voiding once or twice during the night. Conclusions Orthotopic neobladder reconstruction with preservation of gynecologic organs is feasible for female bladder cancer patients. Although the follow-up period was not long, the present technique provided acceptable oncological outcome and voiding function.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Carcinoma, Transitional Cell - pathology</subject><subject>Carcinoma, Transitional Cell - surgery</subject><subject>Cohort Studies</subject><subject>Cystectomy - adverse effects</subject><subject>Cystectomy - methods</subject><subject>Fallopian Tubes - surgery</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Genitalia, Female - surgery</subject><subject>Humans</subject><subject>Immunohistochemistry</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Minimally Invasive Surgical Procedures - methods</subject><subject>Neoplasm Staging</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Ovary - surgery</subject><subject>Postoperative Complications - physiopathology</subject><subject>Quality of Life</subject><subject>Reconstructive Surgical Procedures - adverse effects</subject><subject>Reconstructive Surgical Procedures - methods</subject><subject>Recovery of Function</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Treatment Outcome</subject><subject>Tumors of the urinary system</subject><subject>Urinary Bladder Neoplasms - pathology</subject><subject>Urinary Bladder Neoplasms - surgery</subject><subject>Urinary Reservoirs, Continent</subject><subject>Urinary system involvement in other diseases. Miscellaneous</subject><subject>Urinary tract. Prostate gland</subject><subject>Urination - physiology</subject><subject>Urodynamics</subject><subject>Urology</subject><issn>0090-4295</issn><issn>1527-9995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUsGO0zAQjRCI7S58AsgXxGVT7AQ7MQcQVBRWWlEktlwtx5kUF8cudrIov8bXMaEFJC5II43teW88fs9Z9ojRJaNMPNsvxxhc2E3LglK5pDVGeSdbMF5UuZSS380WWKD580Lys-w8pT2lVAhR3c_OmJRCliVbZD-2A8Qx5ZdkrZ0LB6s9uRkbwIPNrY4TZu1b8lnvrNd5Ouho_Y6spjSAGUI_kXVA2ndoSTORbZ6-6AOurxxoRz5AaJxuW4hkFXwa4mgGGzzpQiRr6LUD8uZ3XXuD6aMeLPghvSAbb-bXWYN95gHWo_9Fxu1mHEzoIT3I7nXaJXh4yhfZdv32ZvU-v968u1q9vs4NZ3zIGdO6kqJigsnCFBU3vKCmgboUEnQJpZEd1J1gNWfUsJZ1tW5Mq40whuuKlxfZ02PfQwzfRkiD6m0y4Jz2EMakKhSyrGhZI5IfkSaGlCJ06hBtjyoqRtXsmtqrk2tqdk3RGqNE3uPTDWPTQ_uXdbIJAU9OAJ1QkS6iXDb9wRWFpEKKedRXRxygHrcWokoGBTXQ2oh-qTbY_47y8p8Oxlk_2_AVJkj7MEb0ICmmUqGo-jR_sfmHYSoq7Fv-BAMb0GU</recordid><startdate>20100601</startdate><enddate>20100601</enddate><creator>Koie, Takuya</creator><creator>Hatakeyama, Shingo</creator><creator>Yoneyama, Takahiro</creator><creator>Hashimoto, Yasuhiro</creator><creator>Kamimura, Noritaka</creator><creator>Ohyama, Chikara</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20100601</creationdate><title>Uterus-, Fallopian Tube-, Ovary-, and Vagina-sparing Cystectomy Followed by U-shaped Ileal Neobladder Construction for Female Bladder Cancer Patients: Oncological and Functional Outcomes</title><author>Koie, Takuya ; Hatakeyama, Shingo ; Yoneyama, Takahiro ; Hashimoto, Yasuhiro ; Kamimura, Noritaka ; Ohyama, Chikara</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c515t-11aa796716192c275c520cbe8369ea3e3c9fe8f618510c1d1f8abcdac6cc5a753</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Carcinoma, Transitional Cell - pathology</topic><topic>Carcinoma, Transitional Cell - surgery</topic><topic>Cohort Studies</topic><topic>Cystectomy - adverse effects</topic><topic>Cystectomy - methods</topic><topic>Fallopian Tubes - surgery</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Genitalia, Female - surgery</topic><topic>Humans</topic><topic>Immunohistochemistry</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Minimally Invasive Surgical Procedures - methods</topic><topic>Neoplasm Staging</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Ovary - surgery</topic><topic>Postoperative Complications - physiopathology</topic><topic>Quality of Life</topic><topic>Reconstructive Surgical Procedures - adverse effects</topic><topic>Reconstructive Surgical Procedures - methods</topic><topic>Recovery of Function</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Treatment Outcome</topic><topic>Tumors of the urinary system</topic><topic>Urinary Bladder Neoplasms - pathology</topic><topic>Urinary Bladder Neoplasms - surgery</topic><topic>Urinary Reservoirs, Continent</topic><topic>Urinary system involvement in other diseases. Miscellaneous</topic><topic>Urinary tract. Prostate gland</topic><topic>Urination - physiology</topic><topic>Urodynamics</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Koie, Takuya</creatorcontrib><creatorcontrib>Hatakeyama, Shingo</creatorcontrib><creatorcontrib>Yoneyama, Takahiro</creatorcontrib><creatorcontrib>Hashimoto, Yasuhiro</creatorcontrib><creatorcontrib>Kamimura, Noritaka</creatorcontrib><creatorcontrib>Ohyama, Chikara</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Urology (Ridgewood, N.J.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Koie, Takuya</au><au>Hatakeyama, Shingo</au><au>Yoneyama, Takahiro</au><au>Hashimoto, Yasuhiro</au><au>Kamimura, Noritaka</au><au>Ohyama, Chikara</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Uterus-, Fallopian Tube-, Ovary-, and Vagina-sparing Cystectomy Followed by U-shaped Ileal Neobladder Construction for Female Bladder Cancer Patients: Oncological and Functional Outcomes</atitle><jtitle>Urology (Ridgewood, N.J.)</jtitle><addtitle>Urology</addtitle><date>2010-06-01</date><risdate>2010</risdate><volume>75</volume><issue>6</issue><spage>1499</spage><epage>1503</epage><pages>1499-1503</pages><issn>0090-4295</issn><eissn>1527-9995</eissn><coden>URGYAZ</coden><abstract>Objectives To evaluate oncological outcomes and voiding functions after orthotopic neobladder reconstruction with preservation of gynecologic organs in female bladder cancer patients. Methods A total of 30 consecutive female patients who underwent radical cystectomy and U-shaped ileal neobladder (constructed using 40 cm of a double-folded ileal loop) substitution were retrospectively analyzed. Of the 30 patients, 29 had urothelial carcinoma and 1 had leiomyosarcoma. Computed tomography was performed every 6 months. Urethroscopic examination was performed at 3-month intervals during the first and second years, and at 6-month intervals thereafter. Pressure flow studies, including urethral pressure profilometry, were performed 3, 6, 9, and 12 months after surgery. Results During a median follow-up of 35.7 months, 1 patient exhibited local recurrence and 6 patients died of bladder cancer. Maximum neobladder pressure examined 12 months after surgery improved significantly as compared with that examined after 3 months ( P <.01). Maximal urethral closure pressure also improved significantly 12 months after surgery as compared with that after 3 months ( P <.05). The capacity of the ileal neobladder 3 months after operation was 204 ± 84 mL, and it showed a gradual increase, reaching 311 ± 95 mL at 12 months ( P <.01). None of the patients required catheterization for residual urine. Twenty-four patients (80%) remained completely dry day and night, voiding once or twice during the night. Conclusions Orthotopic neobladder reconstruction with preservation of gynecologic organs is feasible for female bladder cancer patients. Although the follow-up period was not long, the present technique provided acceptable oncological outcome and voiding function.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>19969331</pmid><doi>10.1016/j.urology.2009.08.083</doi><tpages>5</tpages></addata></record> |
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| subjects | Aged Aged, 80 and over Biological and medical sciences Carcinoma, Transitional Cell - pathology Carcinoma, Transitional Cell - surgery Cohort Studies Cystectomy - adverse effects Cystectomy - methods Fallopian Tubes - surgery Feasibility Studies Female Follow-Up Studies Genitalia, Female - surgery Humans Immunohistochemistry Medical sciences Middle Aged Minimally Invasive Surgical Procedures - methods Neoplasm Staging Nephrology. Urinary tract diseases Ovary - surgery Postoperative Complications - physiopathology Quality of Life Reconstructive Surgical Procedures - adverse effects Reconstructive Surgical Procedures - methods Recovery of Function Retrospective Studies Risk Assessment Treatment Outcome Tumors of the urinary system Urinary Bladder Neoplasms - pathology Urinary Bladder Neoplasms - surgery Urinary Reservoirs, Continent Urinary system involvement in other diseases. Miscellaneous Urinary tract. Prostate gland Urination - physiology Urodynamics Urology |
| title | Uterus-, Fallopian Tube-, Ovary-, and Vagina-sparing Cystectomy Followed by U-shaped Ileal Neobladder Construction for Female Bladder Cancer Patients: Oncological and Functional Outcomes |
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