An ideal bladder replacement technique must fulfill the following criteria: (1) the reservoir must be constructed from ileum only; (2) a metabolically trouble-free safe length of the ileum segment should be used (approximately 60 cm). Any unnecessary waste of ileum length (nipple construction, ileal chimney to accept ureters, etc.) of the ileal segment used for the reservoir construction has to be avoided; (3) the minimum length of a totally detubularized ileum segment is also 60 cm to guarantee a night-time urinary control without the need to wake up and urinate two to three times per night or the need for diapers; (4) the afferent nipple construction should be time-saving and trouble-free, as in the simple Le Due ureteroileal antireflux technique. These requirements are at present ideally fulfilled by the ileal neobladder; this has the distinct advantage of being the simplest of the numerous bladder replacement techniques available.
展开▼