Outcome of sigmoid compared to ileal orthotopic bladder substitution in terms of micturition and defecation parameters in an 8-year long-term follow-up.

Introduction: Various techniques have been described for orthotopic bladder substitution. Bladder substitution with sigma is rather classed as a useful alternative standby. We report the long-term results of sigmoid neobladder in comparison to ileal neobladder with respect to urodynamic and defecation parameters.

Patients And Methods: We matched 10 patients with sigmoid neobladder (mean age 62.6 +/- 10.9) and 10 patients with ileal neobladder (mean age 66.4 +/- 10.2). Mean follow-up for sigmoid neobladder was 8.1 +/- 2.1 years and 7.2 +/- 1.9 years for the ileal neobladder. Each patient was evaluated by medical history, the SF-36 questionnaire, physical examination and urodynamics.

Results: Bladder capacity differed significantly between both groups (sigmoid neobladder 619 ml, ileal neobladder 422 ml). Pressure showed a slight statistical difference (sigmoid neobladder 15 +/- 3 cm H(2)O, ileal neobladder 18 +/- 4 cm H(2)O). The defecation frequency varied significantly between the two groups (sigmoid neobladder 1.1/day, ileal neobladder 3.1/day, p < 0.0001). The SF-36 questionnaire showed no significant difference.

Conclusion: Orthotopic bladder substitution with sigmoid segments has shown equivalent results compared to orthotopic ileal bladder substitution. The sigmoid neobladder is a useful alternative to the ileal neobladder.