Introduction/Objective. Vesica ileale Padovana is the surgical technique for
reconstruction of lower urinary tract following radical cystectomy using
isolated ileal segment. This operative technique requires dissection of both
ureters in full length, that can?t be possible in some cases. The paper is
aimed to present our experience with modified surgical technique of vesica
ileale Padovana using 40 cm of an isolated ileal segment and initial results.
Methods. 10 male patients received modified ileal neobladder following
radical cystectomy at our institution during the period 2008 to 2011. The
mean age of patients was 59 years (45-70). Median follow-up was 76 months
(62-93). Patients were monitored cautiously for functional outcome, local
recurrence, and distant progression. Results. Perioperative, early and late
postoperative mortality have not been noticed. There were only 2 major
complications: prolonged postoperative ileus and prolonged urinary leakage
requiring percutaneous nephrostomy and subsequent ureteral reimplantation due
to stenosis of ureterovesical anastomosis in 1 patient (10 %), respectively.
Average ileal neobladder capacity was 450 ml. Daytime and night continence
were achieved in 9 (90%) and 7 (70%) of patients, respectively. Conclusion.
This modification of orthotopic ileal neobladder has not been difficult to
perform in our hands. Modified technique provides a clear advantage in easier
ureteral implantation more proximally than in the original technique,
requiring less length of ureters. Initial encouraging results should be
confirmed in further clinical practice.
Modified orthotopic ileal neobladder - surgical technique and initial results