Background/Aim. Radical cystectomy is the method of choice in management of
muscle invasive, organ-confined tumors of the bladder (?2-?4, N0-Nx). The
most frequent continent orthotopic urinary diversion after radical cystectomy
is the ileal neobladder. A modified technique consists of using a shorter
segment of the terminal ileum than the standard technique, around 30 cm. The
aim of this study was to determine the urodynamic characteristics of the
orthotopic ileal neobladder created by a modified technique. Methods. In this
prospective clinical study we analyzed the urodynamic parameters of 24
patients who had underwent radical cystectomy with orthotopic urinary
diversion by ileal neobladder created using a modified technique. In all the
patients we performed invasive and noninvasive urodynamic investigations 12
months after the operation. The urethral pressure profile parameters analyzed
were maximal urethral pressure, maximal urethral closure pressure and the
functional urethral profile length. Results. The average age of the patients
was 63 (49-73) years, 90% were males and 10% were females. The median length
of the shorter segment of the terminal ileum was 28 (range 22-35) cm. Prior
to enterocystometry and uroflowmetry postvoid residual (PVR) urine was
measured by a urethral catheter. The median PVR was 16.7 (0-140) mL. The
median enterocystometric capacity was 396 (range 372-532) mL. The median end
filling pouch pressure was 27.6 (range 20-70) cmH20. The median maximal flow
of urine was 22.1 (range 9.7- 39.5) mL/s and the average flow of urine was
9.61 (range 3.6-17.6) mL/s. Flow time in the analyzed group was 47.5 (range
22-119) s. The median maximal urethral pressure was 54 (range 12-101) cmH2O,
maximal urethral closure pressure 36.6 (range 6-91) cmH2O. Functional
urethral profile length was 14.9 (range 4-37) mm. Conclusion. An ileal
orthotopic pouch created by a modified technique using a shorter segment of
the terminal ileum after 12 months presents with urodynamic characteristics
similar to the native bladder.