Complications and neobladder function of the Hautmann orthotopic ileal neobladder

OBJECTIVE To report the complications and function of the Hautmann orthotopic ileal neobladder PATIENTS AND METHODS In a 6.5-year period, 67 patients had an ileal neobladder constructed after radical cystectomy as treatment for invasive carcinoma of the bladder. All complications were reported systematically. Neobladder function was assessed by patient interviews, uroflowmetry and cystometric analyses. RESULTS There were early complications in 41 patients (61%), and late complications in 32 (48%); 23 (34%) had both early and late complications and 17 (25%) had none. Eighteen of the patients (27%) required a re-operation for complications. At the 4-month follow-up, 90% were continent during the day and 65% during the night; at 1 year after surgery 95% were continent during the day and 73% during the night. The functional bladder capacity and maximum cystometric capacity were close to the natural bladder volume (median 450 and 480 mL, respectively). CONCLUSIONS Despite the high rate of complications in this study, most were considered as minor and could be treated by conservative or minimally invasive methods. The neobladder had an acceptable resemblance to the native bladder in capacity and function. Consequently the ileal neobladder might be preferred as a urinary diversion after radical cystectomy, if no contraindications are present.