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Year : 2019  |  Volume : 15  |  Issue : 8  |  Page : 51-55

Modified U-Shaped ileal neobladder designed for facilitating neobladder-urethral anastomosis in extracorporeal reconstruction after robotic-assisted radical cystectomy

1 Department of Urology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
2 Department of Urology, Shuang Ho Hospital, New Taipei City; Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

Correspondence Address:
Dr. Chen-Hsun Ho
No. 291, Zhongzheng Road, Zhonghe, New Taipei City, 235
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcrt.JCRT_538_17

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Background/Objective: To report the initial experience and the early outcomes of a modified U-shaped ileal neobladder, which was developed to facilitate the neobladder-urethral anastomosis by minimizing the anastomotic tension. Patients and Methods: Between June 2015 and December 2016, two male and two female patients (median age: 65.5 years, range: 43–72 years) underwent the modified U-shaped ileal neobladder after robotic-assisted radical cystectomy (RARC). The most mobile and dependent ileal segment was first selected intracorporeally as the site for later neobladder-urethral anastomosis. The neobladder was formed extracorporeally, and the previously selected ileal segment formed the most dependent portion of the neobladder. The neobladder-urethral anastomosis was completed after robotic redocking. Results: The median follow-up was 8 months (3–21 months). The median operative time, console time, and extracorporeal reconstruction time were 620 min (534–674 min), 372 min (314–420 min), and 151 min (128–215 min), respectively. In all patients, the neobladder-urethral anastomosis was completed intracorporeally with minimal tension. The median hospital time after the surgery was 14.5 days (14–19 days). Postoperatively, the median peak flow rate and void volume were 10 ml/s (4–35 ml/s) and 258 ml (88–775 ml). The median postvoid residual was 20 ml (10–53 ml). At daytime, two were completely continent; the other two reported mild (1–2 pads) and moderate (>2 pads) incontinence at the postoperative 3 and 4 months, respectively. Three reported nocturnal enuresis. Conclusions: Our initial experience demonstrated that the modified U-shaped neobladder designed for minimizing the anastomotic tension is safe and feasible with its satisfactory functional outcomes.

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