Our technique in orthotopic neobladder

: The strive in the field of orthotopic neobladders derives from the need to improve their morphofunctional aspects and to simplify the surgical procedures. The Authors propose their experience on a new method of orthotopic neobladder in 8 patients submitted to radical cystectomy for advanced bladder neoplasia from march 91 until june 93. The surgical technique was to prepare a reservoir with a simile Camey 2 type procedure modified by them using 50 cm of ileus, 30 of which detubularized and reconfigured into a simile spheric shape with Polygia 75 staplers. The remaining length was left intact for the ureteral anastomosis performing the Wallace 1 type procedure. The advantages of this technique are that: the neobladder is prepared rapidly using staplers, thus reducing operating time the presence of an isoperistaltic segment of ileus for ureteral anastomosis permits an reduced ureteral mobilization with a low probability of reflux a simple reconversion in ileal conduit in case of reservoir failure or neoplastic urethral recurrence is possible. The criteria for selecting the patients are reported and the diagnostic algorithm regarding the follow-up presented. The latter is done with biochemical, echographic, radiological and pressure studies, every 4-6 or 12 months. Particular attention has been focused on the quality of life in relation to the diurnal/nocturnal continence and micturation interval. They conclude that this technique is surgically simple and rapid with satisfactory clinical and urodynamic results.