정위 방광대치술을 시행받은 남자 방광암 환자에서 배뇨양상과 요실금의 경과
Voiding Pattern and Incontinence after Orthotopic Ileal Neobladder in Male Patients
남정수, 조성태, 이영구,
소속 상세정보
남정수 ( Nam Jung-Su )
한림대학교 의과대학 비뇨기과학교실
조성태 ( Cho Sung-Tae )
한림대학교 의과대학 비뇨기과학교실
이영구 ( Lee Young-Goo )
한림대학교 의과대학 비뇨기과학교실
KMID : 0358320070480010012
Abstract
Purpose: To report the voiding pattern and continence stati in male patients having undergone a radical cystectomy and orthotopic bladder substitution.
Materials & Methods: Between March 2000 and June 2005, 20 men with advanced bladder cancer had a radical cystoprostatectomy and urinary diversion via an ileal orthotopic bladder substitution. The voiding pattern and continence stati were assessed using patient interviews, frequency- volume charts and pad tests at 1, 3, 6, 9 and 12 months after catheter removal.
Results: The mean age and follow-up were 60.5 years(41-72) and 34.1 months (12-69), respectively. Neobladder substitution was performed with an ileum in all patients. 17 patients had reconstruction with a Studer neobladder and 3 with a W-pouch Hautmann. All patients had transitional cell carcinoma(TCC) and their tumor stages ranged from T1G3 to T4aN1M0. The frequency of voiding ranged from 4 to 12 times during the day, and 0 to 5 times during the night, with a mean maximum neobladder capacity of 336ml(200-620) and maximum flow rate of 24.6ml/sec(12-46) 12 months after removal of the catheter. No patient required intermittent self-catheterization. All-time continence rates were 15, 30, 65 and 85%, and all-time incontinence rates were 55, 25, 10 and 5% at 1, 3, 6 and 9 months after catheter removal, respectively.
Conclusion: Orthotopic bladder substitution has an excellent functional outcome over time, resulting in high daytime and nighttime continence rates within 9 months of catheter removal.(Korean J Urol 2007;48:12-17)
키워드
Bladder neoplasms; Urinary incontinence; Urinary reservoirs; continent
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