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Query: UMLS:C0005684 (bladder cancer)
 16,431 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sigmoid colon was used to replace the bladder after radical cystoprostatectomy in 10 patients with bladder cancer. A U- or J-shaped segment of the sigmoid colon was anastomosed at the most dependent portion to the urethral stump. The ureters were implanted in each end of the loop via an antireflux tunneling technique. There was no operative mortality, and the complications associated with this form of bladder replacement were minimal. All 10 patients had sensations of filling, and 8 of 10 achieved full daytime continence with complete voluntary emptying. Enuresis was present in all patients and required condom catheters during sleep, which were well tolerated. We believe that a tubular sigmoid segment is an acceptable alternative to tubular ileum or cecum for total bladder replacement.
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PMID:Bladder replacement with sigmoid colon after radical cystoprostatectomy. 356 9

Total bladder replacement with tubular sigmoid colon and detubularized ileocecal bowel segments was performed on 17 patients after cystoprostatectomy for bladder cancer. There were few complications and patient acceptance was excellent. Daytime continence was achieved in most patients but voiding patterns were superior with detubularized segments. However, enuresis was common with both segment types. Total urinary continence (day and nighttime continence) was achieved in 7 patients with an artificial urinary sphincter that was activated only at night. Total bladder replacement is an acceptable form of urinary diversion after cystoprostatectomy in appropriate patients.
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PMID:Bladder replacement after cystoprostatectomy: efforts to achieve total continence. 362 47

Since 1987, 30 patients with bladder cancer underwent cystoprostatectomy with bladder replacement via ileocecourethrostomy. Multiple transverse teniamyotomies were made in the cecum to assure a large capacity reservoir with low pressures. The particular anatomy and physiology of the cecum, short length of the intestinal segment needed and teniamyotomies are the 3 factors that have allowed for good functional and metabolic results. All patients achieved daytime continence. After 3 years of followup 67% of the patients were continent at night if they voided every 3 or 4 hours and 22% if they voided every 2 or 3 hours, while 11% experienced enuresis. Urodynamic data after 1 year showed a mean capacity of 396 ml. for the new bladder, a mean full filling pressure of 28 cm. water and a mean maximum pressure of 55 cm. water. Post-micturition residual urine volume was consistently less than 55 ml. These results indicate that the ileocecal segment can be enlarged with myotomies through the tenia to produce an adequate capacity and a low pressure bladder replacement without the need for formal detubularization.
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PMID:Results of 4 years of experience with bladder replacement using an ileocecal segment with multiple transverse teniamyotomies. 845 33

Transurethral resection (TUR) is now widely used in combined treatment of urinary bladder cancer, but the procedure may be compromised if applied without evaluation of infiltration and malignancy degree and metastases responsible for frequent recurrences. The aim of this study was design of effective measures to prevent TUR complications. For 8 years the surgeons from the Moscow Medical Academy urological clinic made 824 TURs for bladder tumors in 322 patients (mean age 57.5 years, 72.6% of males, 27.4% of females). At the stage T3-4 TUR was conducted in contraindications to cystectomy or absence of distant metastases. The following intra- or postoperative complications were observed: hemorrhages (4.6%), intraperitoneal perforations (0.3%), extraperitoneal perforations (0.9%), vesicoureteral reflux (2.8%), enuresis (1.2%). The emergence and severity of the complications were dependent on the bladder tumor stage and degree of infiltration of the muscular layer. Positive TUR results are more feasible in more strict approach to the indications for surgery, adequate surgical skills and technique, high-quality anesthesia, early arrest of hemorrhage, low pressure of the washing liquid in the course of operation.
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PMID:[The complications of transurethral resection of the bladder for tumor]. 867 46

We subjected to a functional and metabolic evaluation (urodynamic examination + cystography) 10 patients underwent to radical cystectomy with a ileal orthotopic reservoir (VIP) for bladder cancer. At the moment patients have a minimum 3-years follow-up and they are out of disease. The medium capacity of the reservoir is about 447 ml, with a low pressure flow, a medium pressure of ureteral closing of 62.5 cm of H2O. At the cystography neither ureteral reflux nor post miction residuum have been proved. All the patients are continent, with the exception of one patient suffering from episodes of nocturnal enuresis. The metabolic evaluation hasn't proved substantial changes except the presence of hypocitraturia in the only patient in metabolic acidosis. In conclusion the ileal orthotopic reservoir showed a good long-term functionality without considerable complication of metabolism.
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PMID:[Orthotopic ileal neobladder: urodynamic and metabolic aspects. Our experience]. 902 36

Reconstruction of the lower urinary tract using intestinal segments has become a standard component of the treatment of patients with bladder cancer. A variety of intestinal segments can be successfully used for this purpose. Between 1986 and 1998, the authors have used a composite ileocolic segment for neobladder reconstruction in patients desiring orthotopic reconstruction of the lower urinary tract. The early and late complication rates are 11% and 30%, respectively. Forty-five percent of men are potent postoperatively. Seventy-six percent of patients are continent both day and night. Three percent of our patients experience nocturnal enuresis, and 15% perform clean intermittent catheterization. Bothersome daytime stress urinary incontinence occurs in 3% of patients evaluated for this report. Although no contemporary studies demonstrate the superiority of a particular bowel segment for lower urinary tract reconstruction, the authors' long-term experience with the ileocolic neobladder suggests that this composite segment provides excellent results for lower urinary tract reconstruction after radical cystectomy.
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PMID:Orthotopic ileocolic neobladder reconstruction following radical cystectomy: history, technique and results of the Johns Hopkins experience, 1986-1998. 1008 56

Orthotopic neobladder reconstruction has become a standard procedure in patients undergoing radical cystectomy for invasive bladder cancer. In addition the known sequelae like nocturnal enuresis, need of self-intermittent catherisation and stricture at urethro or ureteroileal anastomosis, one of the most unfortunate event to happen is the recurrence of malignancy that may require the removal of the neobladder lessening the quality of life suddenly. There is a little information about the cases of urethral recurrence of transitional cell carcinoma of the bladder after cystectomy and orthotopic neobladder. We report such a case and management dilemma as the patient is young and does not want to loose body image and a brief review of literature is presented.
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PMID:Urethral recurrence after sigmoid orthotopic neobladder. What should be the ideal treatment approach? 1457 94