Objective: The aim of this study was to compare advantages and disadvantages of using double-J or external stents to preserve the uretero-ileal anastomosis in patients receiving an orthotopic neobladder. Methods: 77 consecutive patients with bladder cancer who underwent radical cystoprostatectomy and Studer neobladder were evaluated. All patients received a direct spatulated end-to-side uretero-ileal anastomosis in the afferent loop (Nesbit technique). In 45 patients (group A), the stents (Bracci ureteral splint) were brought our through the reservoir and anchored to the skin; in 32 patients (group B), an internal double-J stent was used. Median follow-up was 30 months. Results: 9 (11.5%) uretero-ileal anastomosis strictures in group A and 7 (11.6%) in group B were observed. There was a significant difference in the side of stricture with a greater prevalence on the left side (p <0.004). Stricture formation and side were not related to the type of stent used. 14 (20%) neobladder-ureteral refluxes occurred, with a non-significant difference between the two groups (p = 0.37). 12 patients (86%) were asymptomatic; two patients developed pyelonephritis and needed antibiotic treatment, Neobladder catheter was removed after 17 days (range: 15-18 days) and 14 days (range: 12-15 days), respectively, in group A and group B with an earlier discharge of the patients in group B. There was a significant difference in mean hospital stay between the two groups (Mann-Whitney test p <0.0001). Discomfort related to the stent was mild for most of the patients of group B (84%). Conclusions: Internal stenting is an equally effective alternative to external stent in patients undergoing bladder replacement. The use of double-j stents appears to be associated with minimal discomfort, earlier mobilization and a shorter hospital stay. Copyright (C) 2001 S, Karger AG, Basel.
Micali, S., De Carli, P., Miano, R., O'sullivan, D., Lamanna, L., & Micali, F. (2001). Double-J ureteral stents: An alternative to external urinary stents in orthotopic bladder substitution. EUROPEAN UROLOGY, 39(5), 575-579.
|Tipologia:||Articolo su rivista|
|Citazione:||Micali, S., De Carli, P., Miano, R., O'sullivan, D., Lamanna, L., & Micali, F. (2001). Double-J ureteral stents: An alternative to external urinary stents in orthotopic bladder substitution. EUROPEAN UROLOGY, 39(5), 575-579.|
|IF:||Con Impact Factor ISI|
|Settore Scientifico Disciplinare:||Settore MED/24 - Urologia|
|Revisione (peer review):||Sì, ma tipo non specificato|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1159/000052506|
|Stato di pubblicazione:||Pubblicato|
|Data di pubblicazione:||2001|
|Titolo:||Double-J ureteral stents: An alternative to external urinary stents in orthotopic bladder substitution|
|Autori:||Micali, S; De Carli, P; Miano, R; O'sullivan, D; Lamanna, L; Micali, F|
|Appare nelle tipologie:||01 - Articolo su rivista|