Replacement bladders in Oltrepo
1996
: In our Department we performed 269 radical cystectomies from January 1985 to April 1996. As regard the urinary diversion 64 patients were undergone to a cutaneous ureterostomy; in 137 we performed a Wallace uretero-intestinal anastomosis; in 6 a Mauclaire rectal diversion; in 12 patients a Mainz Pouch II and 50 selected patients (44 man and 6 ladies) we performed a Vesica Ileale Padovana (VIP). In these cases the stage was lowly, good renal function, no are hydronephrosis. The patients were motivated for a long follow-up and preoperatively undergone to urethral biopsies. We have had the following complications: an early bowel obstruction, 4 wound infections and for the long term follow-up 2 inguinal hernias, 1 laparocele, 5 patients with bilateral hydronephrosis. At the moment we cannot state a correct oncological report for the short follow-up: only 1 patient died after 18 months for a pelvic relapse. We can suggest that VIP is a good solution for the ladies: its mandatory to take care of the urethra and the pelvic floor for a good continence limiting the lymphadenectomy. We haven't any suggestions about the deep of the colpectomy and the opportunity of the vaginal suspension.
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