1 Jul 2015Article
VIP neobladder (Padovana) reconstruction following radical cystectomy for bladder cancer Complications, functional outcome and quality of life evaluation in 95 cases.
Nikolaos Kostakopoulos 1Vassilis Protogerou 2Andreas Skolarikos 1Ioannis Varkarakis 1Athanasios Papatsoris 1Theodore Troupis 3Maria Piagou 3Charalambos Deliveliotis 1
Affiliations
Article Info
1 2nd Department of Urology, Sismanoglion Hospital, Athens Medical School, Athens, Greece
2 Department of Anatomy, Athens Medical School, Athens, Greece; Department of Urology, “Attikon”, University Hospital, Athens Medical School, Athens, Greece
3 Department of Anatomy, Athens Medical School, Athens, Greece
Ann. Ital. Chir., 2015, 86(4), 362-367;
Published: 1 Jul 2015
Copyright © 2015 Annali Italiani di Chirurgia
This work is licensed under a Creative Commons Attribution 4.0 International License.
Abstract
The Authors report a complete study concerning complications, the imaging and functional results, the clinical outcome and the quality of life in patients treated with VIP. 95 patients with localized bladder TCC (T2N0M0) were evaluated. Follow up points were 1st, 3rd, 6th, 12th, 18th, 24th and 36th month with clinical and ultrasound evaluation. At 6th, 12th and 36th month CT pyelography and urodynamic evaluation were performed and we used a questionnaire for subjective bladder function and the EORTC QLQ C-30 questionnaire to evaluate quality of life. Perioperative complications were ileus (2 patients; 2.1%) (Clavien Grade IIIb), one postoperative death (1.0%) (Clavien Grade V) and a resuscitated cardiac arrest (1.0%) (Clavien Grade IVa). Postoperative complications were incisional hernias (n=4 patients; 4.21%) (Clavien Grade I) and hydronephrosis in five patients (5.26%) due to ureteric/neobladder stricture (Clavien Grade IIIb). Urine retention due to neobladder neck stenosis was observed in one patient (1.0%) (Clavien Grade IIIb) and an ileo-neobladder fistula in one (1.0%) patient (Clavien Grade IIIb). During follow up there were two cancer related deaths (2.1%). According to urodynamic evaluations neobladder capacity increased, end-filling pressure and Qmax decreased while residual urine and the number of intrinsic contractions remained stable. Continence rates and quality of life were high and stable during follow up. VIP technique for bladder substitution is a relatively easy technique with low rate of complications, good functional results which respect the patient’s quality of life.
Keywords
- Bladder cancer
- Neobladder
- Padovana
- Quality of life
- Radical cystectomy
- VIP