Functional evaluation of a modified Studer ileal neobladder

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ObjectivesTo evaluate the results of using a shorter ileal segment (40cm only) in reconstructing Studer ileal neobladder after radical cystectomy. Subjects and methodsRadical cystectomy and modified Studer ileal neobladder was performed in 60 patients for invasive bladder cancer. Only 40cm of the ileum was used; 32cm segment for constructing the body of the neobladder, while the remaining 8cm as an isoperistaltic intact limb for ureteral reimplantation. After one year, evaluation included clinical, laboratory, radiographic and urodynamic studies to determine the functional and oncological outcomes. ResultsEarly complications occurred in 5 patients (8.6%). According to the modified Clavien system, two patients had grade I complications, IIIb occurred in one patient and two patients had grade V complications. Late complications (8.6%) included incisional hernia in 2 patients, deep venous thrombosis, bilateral uretero-ileal anastomotic stricture and intestinal obstruction each occurred in one patient. At one year, daytime and nighttime continence was 93.1% and 89.7%, respectively. Reflux was observed in 6 patients (10.3%) which was unilateral in 3 patients and bilateral in 3 without affecting the renal functions. Neobladder pressure was 7–18cmH2O at half capacity and 13–38cmH2O at full capacity with no uninhibited contractions. ConclusionMinimizing the length of the ileum for Studer neobladder reconstruction is feasible and with acceptable results.