1999 Fiscal Year Final Research Report Summary
An observation of micturition and QOL subsequent to ileal neobladder construction that enables the natural voiding through urethra after total cystectomy.
| Project/Area Number |
09671607
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Urology
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| Research Institution | The University of Tokyo |
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Principal Investigator |
HOSAKA Yoshio Branch Hospital, Faculty of Medicine, The University of Tokyo, Associate Professor, 医学部・附属病院分院, 助教授 (70133080)
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| Co-Investigator(Kenkyū-buntansha) |
KITAMURA Tadaichi Faculty of Medicine, The University of Tokyo, Professor, 医学部・附属病院, 教授 (70010551)
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| Project Period (FY) |
1997 – 1999
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| Keywords | Total cystectomy / Natural voiding / Ileal neobladder construction / Micturition function / QOL / Bladder cancer |
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| Research Abstract |
A total of 23 patients have received ileal neobladder construction in association with total cystectomy and 21 were eligible for the evaluation of micturition status and quality of life (QOL) in 6 months or more postoperatively.
The mean observation period was 34.3 months ( 6 months to 5 years ). Twenty had bladder cancer and another had bladder tuberculosis_ Nineteen received the surgery that we had modified the original Melchier method. One received Indiana Patch method and another received Le Bag method. Three died of cancer, 4 were alive having cancer and 13 were alive without cancer.
Intravenous pyelography and/or CT revealed no hydronephrosis. In 13 patients who received vesicoureteral reflux (VUR) examination, 3 showed grade 1 to 2 VUR. In 20 patients who received urodynamic examination, 4 showed uninhibited contraction (UIC). Nevertheless, the neobladder gained stability with time and the UIC disappeared by one year postoperatively. Therefore, we evaluated the first desire to void and maximum bladder capacity in one year or more postoperatively. They were 200ml and 350ml, respectively. At the same time, the patients showed the average of 6.0ml/ sec of mean voiding stream and 16.0ml/ sec of maximum voiding stream using uroflowmetry. The average urethral closure pressure was 20ml. MRI image revealed no pouch cele finding and only one case was thinking of night-pad application for nocturnal incontinence. No patients performed intermittent self catheterization. The cases passed 5 years or more from the operation were all stable and content with the voiding status. Moreover, relatively young patients enjoyed the sex life almost as same as the preoperative status.
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