To create a simple neobladder and determine whether the double-limb U-Pouch (D-LUP) has the same capacity and compliance as a Studer or Camey I neobladder. To develop an orthotopic diversion that can be applied to robotic surgery with laboratory data supporting the concept.
Materials and Methods
Kidneys, ureters, bladders, and small intestine were obtained from pigs at the time of scheduled autopsy after completion of institutionally approved investigational trauma protocols. A Camey I neobladder, spherical neobladder, and D-LUP, were constructed from 40-cm segments of small intestine. They were compared for capacity, compliance, and pouch-to-urethra anastomotic distance.
The cystometric capacity at 30 cm H2O for the Camey I, Studer, and D-LUP neobladders were 250 mL, 350 mL, and 430 mL, respectively. The pouch-to-urethra anastomotic distance was 0 cm for the Camey I, 10 cm for the spherical reservoir, and 0 cm for the D-LUP. Compliance was 10 mL/cm H20 for the Camey 1, 15 mL/cm H2O for the sphere, and 16 mL/cm H20 for the D-LUP.
The D-LUP neobladder was simple to construct, had a more dependent ileo-urethrostomy site, larger capacity, and similar compliance when compared with a spherical neobladder.
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- Intra-abdominal “reservoir” in patients with permanent ileostomy. Preliminary observations on a procedure resulting in fecal “continence” in five ileostomy patients.Arch Surg. 1969; 99: 223-231
- [A procedure for avoiding reflux in uretero-ileal implantations during enterocystoplasty (author's transl)].J Urol Nephrol (Paris). 1979; 85: 449-454
- 25-year experience with replacement of the human bladder (Camey procedure).J Urol. 2017; 197: S173-S179https://doi.org/10.1016/j.juro.2016.10.106
- Cup-patch technique of ileocystoplasty for bladder enlargement or partial substitution.Surg Gynecol Obstet. 1959; 108: 240-244
- The ileal neobladder.J Urol. 1988; 139: 39-42
- Three years' experience with an ileal low pressure bladder substitute.Br J Urol. 1989; 63: 43-52
- Ureteroenteric strictures after open radical cystectomy and urinary diversion: the University of Southern California Experience.Urology. 2015; 86: 87-91https://doi.org/10.1016/j.urology.2015.03.014
- Lessons from 151 ureteral reimplantations for postcystectomy ureteroenteric strictures: a single-center experience over a decade.Urol Oncol. 2017; 35: 112.e19-112.e25https://doi.org/10.1016/j.urolonc.2016.10.005
- Second stage reconfiguration of Camey I ileal bladder improves its urodynamic and clinical characteristics.Urology. 1994; 44: 425-428
- Twenty years experience with an ileal orthotopic low pressure bladder substitute—lessons to be learned.J Urol. 2006; 176: 161-166https://doi.org/10.1016/S0022-5347(06)00573-8
- The “pitcher pot” ileal neobladder: early experiences.Jpn J Clin Oncol. 2006; 36: 717-722https://doi.org/10.1093/jjco/hyl100
- Comparison of orthotopic sigmoid and ileal neobladders: continence and urodynamic parameters.Eur Urol. 2005; 47: 679-685https://doi.org/10.1016/j.eururo.2004.10.018
- [Orthotopic T pouch ileal neobladder: evaluations of urodynamics and upper urinary tract functions].Zhonghua Yi Xue Za Zhi. 2010; 90: 3099-3102
- Intracorporeal neobladder reconstruction: pressure-flow urodyamic studies in cadaveric orthotopic neobladders.BJU Int. 2012; 109: 434-436https://doi.org/10.1111/j.1464-410X.2011.10403.x
- Robotic radical cystectomy—is the diversion the Achilles' heel?.J Urol. 2014; 192: 1601-1603https://doi.org/10.1016/j.juro.2014.09.042
- Robotic-assisted laparoscopic intracorporeal urinary diversion.Eur Urol. 2010; 57: 1013-1021https://doi.org/10.1016/j.eururo.2009.12.028
- No surgical innovation without evaluation: the IDEAL recommendations.Lancet. 2009; 374: 1089
Published online: December 01, 2017
Accepted: November 21, 2017
Received: October 25, 2017
Financial Disclosure: The authors declare that they have no relevant financial interests.
Published by Elsevier Inc.