Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/22330
Title: Orthotopic Neobladder Reconstruction: Patient Selection And Perspectives.
Authors: Qu, Liang G;Lawrentschuk, Nathan
Affiliation: EJ Whitten Prostate Cancer Research Centre, Epworth Healthcare, Melbourne, VIC, Australia
Department of Urology, Austin Health, Heidelberg, Victoria, Australia
Department of Surgery, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
Issue Date: 2019
EDate: 2019
Citation: Research and reports in urology 2019; 11: 333-341
Abstract: Orthotopic neobladder (ONB) reconstruction is a continent urinary diversion procedure that may be performed in a patient with bladder cancer following a radical cystectomy. The selection of a patient for an ONB reconstruction is strict as not everyone may be suitable to undergo this complex surgery. Patients must be not only mentally competent but also physically dexterous enough to allow for appropriate neobladder training post-procedure, to achieve best urinary function. However, even with a carefully chosen patient population, various complications specific to ONB reconstruction may result. Metabolic acidosis may result from electrolyte shifts, resulting in secondary complications such as bone demineralization and urinary calculi. In addition, nutritional deficiencies may result from the use of a transposed intestinal segment for the fashioning of the reservoir. A widely used outcome measure when assessing for ONB reconstruction is continence. With a strict neobladder training regimen, daytime continence may be achieved in roughly 70% of patients post-ONB procedure. This number may increase over the course of several years, although may decrease in up to 20 years of follow-up. Similarly, quality of life (QoL) measures have been widely studied, and current literature suggests slightly better QoL achieved with ONB compared to other urinary diversion procedures. Of note, the tools used to assess continence and QoL vary between studies, limiting the interpretability of the summarized data. Nevertheless, ONB reconstruction is a procedure that is still evolving, with ongoing modifications that can reduce complications and improve patient urinary function.
URI: http://ahro.austin.org.au/austinjspui/handle/1/22330
DOI: 10.2147/RRU.S181473
ORCID: 0000-0002-5710-1983
0000-0001-8553-5618
PubMed URL: 31850284
ISSN: 2253-2447
Type: Journal Article
Review
Subjects: bladder cancer
neobladder
urinary diversion
Appears in Collections:Journal articles

Files in This Item:
There are no files associated with this item.


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.