We have located links that may give you full text access.
Preservation of the anterior vaginal wall during female radical cystectomy with orthotopic urinary diversion: technique and results.
Journal of Urology 2002 October
PURPOSE: Orthotopic urinary reconstruction has been shown to be a viable option in women undergoing radical cystectomy. However, due to anatomical differences and technical considerations orthotopic diversion has been performed in a relatively small number of patients. We examined our technique of vaginal wall preservation during female radical cystectomy and orthotopic neobladder construction.
MATERIALS AND METHODS: We reviewed the records of all patients who underwent radical cystectomy between January 1994 and December 2001. Of these 542 patients we identified 94 females, of whom 25 (27%) underwent orthotopic neobladder substitution. We reviewed perioperative major and minor complications, postoperative care, followup and pathological results.
RESULTS: Overall 21 of the 25 patients (84%) underwent anterior vaginal wall sparing. Five patients (24%) had minor complications, there were no major perioperative complications and no patients required transfusion. Median estimated blood loss in this group was 575 ml. (range 200 to 1,250). A single neobladder-vaginal fistula developed in a patient early in our series in whom the anterior vaginal wall was incised and repaired during dissection. Of the 21 patients 15 (72%) were continent. Pathological specimens revealed a negative posterior bladder wall and urethral margins in all cases. At a median followup of 12 months 1 patient had local recurrence.
CONCLUSIONS: Anterior vaginal wall preservation in female radical cystectomy with orthotopic neobladder substitution is technically feasible, maintains vaginal length and support, has an acceptable complication rate and can achieve negative margins. Prospective evaluation is needed to assess the long-term impact on functional outcomes and cancer control.
MATERIALS AND METHODS: We reviewed the records of all patients who underwent radical cystectomy between January 1994 and December 2001. Of these 542 patients we identified 94 females, of whom 25 (27%) underwent orthotopic neobladder substitution. We reviewed perioperative major and minor complications, postoperative care, followup and pathological results.
RESULTS: Overall 21 of the 25 patients (84%) underwent anterior vaginal wall sparing. Five patients (24%) had minor complications, there were no major perioperative complications and no patients required transfusion. Median estimated blood loss in this group was 575 ml. (range 200 to 1,250). A single neobladder-vaginal fistula developed in a patient early in our series in whom the anterior vaginal wall was incised and repaired during dissection. Of the 21 patients 15 (72%) were continent. Pathological specimens revealed a negative posterior bladder wall and urethral margins in all cases. At a median followup of 12 months 1 patient had local recurrence.
CONCLUSIONS: Anterior vaginal wall preservation in female radical cystectomy with orthotopic neobladder substitution is technically feasible, maintains vaginal length and support, has an acceptable complication rate and can achieve negative margins. Prospective evaluation is needed to assess the long-term impact on functional outcomes and cancer control.
Full text links
Related Resources
Trending Papers
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
Prevention and treatment of ischaemic and haemorrhagic stroke in people with diabetes mellitus: a focus on glucose control and comorbidities.Diabetologia 2024 April 17
Diagnosis and Management of Cardiac Sarcoidosis: A Scientific Statement From the American Heart Association.Circulation 2024 April 19
Eosinophilic Esophagitis: Clinical Pearls for Primary Care Providers and Gastroenterologists.Mayo Clinic Proceedings 2024 April
Essential thrombocythaemia: A contemporary approach with new drugs on the horizon.British Journal of Haematology 2024 April 9
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app