Thesis (Ph.D.) - Cairo University - National Cancer Institute - Department of Oncology-Surgical

Continuous trials for an ideal urinary reservoir following radical cystectomy for muscle invasive bladder malignancies is the best evidence that an (ideal) orthotopic neo-bladder has not been achieved. Several reconstructive options were proposed, and with these trials new concerns and drawbacks had to be addressed. In 2014, A prospective interventional study was carried out in the National Cancer Institute involving 29 patients with bladder cancer who met the criteria for neobladder reconstruction after radical cystectomy for whom a modified Y shaped ileal neobladder was created after tumor exanteration aiming at exploring the functional results, complications and continence rates for a period of one year in such a group of patients compared to other reconstructive options. Operative time, time to create the neobladder, urodynamics, and complication rates were fairly similar, if not slightly better, than those recorded in different series of neobladder reconstruction. Complications were assessed per the Clavien-Dindo classification system. Continence rates improved significantly through the course of follow up. The search for the ideal orthotopic bladder substitute is still ongoing, different centers around the world have come up with different reconstructive options, each with their merits and drawbacks. Introduction of such an option in the national cancer institute is step towards further improvement and modification in the pathway of neobladder creation for the bladder cancer patients in Egypt

Issued also as CD