Outcome of Sigmoid Compared to Ileal Orthotopic Bladder Substitution in Terms of Micturition and Defecation Parameters in an 8-Year Long-Term Follow-Up

Abstract

Introduction: Various techniques have been described for orthotopic bladder substitution. Bladder substitution with sigma is rather classed as a useful alternative standby. We report the long-term results of sigmoid neobladder in comparison to ileal neobladder with respect to urodynamic and defecation parameters. Patients and Methods: We matched 10 patients with sigmoid neobladder (mean age 62.6 ± 10.9) and 10 patients with ileal neobladder (mean age 66.4 ± 10.2). Mean follow-up for sigmoid neobladder was 8.1 ± 2.1 years and 7.2 ± 1.9 years for the ileal neobladder. Each patient was evaluated by medical history, the SF-36 questionnaire, physical examination and urodynamics. Results: Bladder capacity differed significantly between both groups (sigmoid neobladder 619 ml, ileal neobladder 422 ml). Pressure showed a slight statistical difference (sigmoid neobladder 15 ± 3 cm H₂O, ileal neobladder 18 ± 4 cm H₂O). The defecation frequency varied significantly between the two groups (sigmoid neobladder 1.1/day, ileal neobladder 3.1/day, p < 0.0001). The SF-36 questionnaire showed no significant difference. Conclusion: Orthotopic bladder substitution with sigmoid segments has shown equivalent results compared to orthotopic ileal bladder substitution. The sigmoid neobladder is a useful alternative to the ileal neobladder.