The surgical approach and urinary diversion selection are at the discretion of the patient and surgeon, however, most reports describe the construction of an ileal
neobladder either with preservation of the bladder trigone and ureteral insertion or without trigonal preservation and ureteral reimplantation.
Renal and functional outcomes following cystectomy and
neobladder reconstruction.
In terms of early postoperative acute renal failure, no difference in rate was reported with ileal conduit,
neobladder, and ureterocutaneostomy (6).
The patient underwent radical cystectomy with an orthotopic
neobladder. Anatomopathology confirmed complete resection of the tumor reaching the muscle layer and the perivesical fat.
They include the application of different types of urinary diversion with the creation of a
neobladder as well as nerve-sparing procedures (which can be used in both men and women) (9-11).
Laparoscopic radical cystectomy with novel orthotopic
neobladder with bilateral isoperistaltic afferent limbs: Initial experience.
A 20-year-old male with a preoperative diagnosis of exstrophy--epispadias complex was posted for surgery (Mitrofanoff procedure and
neobladder creation) under epidural and general anaesthesia.
Perioperative outcomes evaluated included estimated blood loss (EBL), operative time (OR time), type of urinary diversion performed (ileal conduit, orthotopic
neobladder, or cutaneous ureterostomy), intraoperative complications, length of stay (LOS), and SSI stratified by time of presentation.
The (http://www.nejm.org/doi/full/10.1056/NEJMicm1611578) report published in the New England Journal of Medicine s aid: "The patient underwent an open neocystolithotomy to extract the
neobladder stone, which was egg shaped and measured 12 cm by 9.5 cm by 7.5 cm (4.7 by 3.7 by 3 inches), weighed 770 g (1.7 pounds), and was composed of 20 percent struvite and 80 percent calcium phosphate (Panel C)."
Total pelvic exenteration with a split-thickness skin graft neovagina, continent orthotopic
neobladder and rectal reanastomosis, resulting in no external ostomies and adequate sexual function.
Patient begins emptying Diversion Begin teaching the the pouch, or irrigating patient to empty the the
neobladder as appropriate.
[8] reported a 60-year-old case of signet-ring cell carcinoma of the urinary bladder successfully treated with radical cystectomy and creation of an ileal
neobladder. The histopathological stage was pT3aN0M0 and adjuvant chemotherapy (TS-1) was performed.
