Early and late cystometry of detubularized and nondetubularized intestinal neobladders: new observations and physiological correlates.

Abstract

We studied the volume and pressure changes with time in detubularized and nondetubularized neobladders. Cystometry was performed at early and late followup in 54 male patients with post-cystectomy intestinal neobladders constructed from an intact ileocecal segment in 33, detubularized sigmoid in 11 and detubularized ileum in 10. With time the capacity of the neobladder increased in all 3 groups. Concomitantly, while intact ileocecal bladders showed an increase in intra-reservoir pressure and persistence of involuntary contractions, detubularized sigmoid and ileal bladders showed a decrease in intra-reservoir pressure and involuntary contractions. Increased capacity with time is not due to detubularization per se but rather to over distension, which is more marked in detubularized (109 to 112%) than in tubular (79%) segments. Detubularized intestinal neobladders not only offer a high capacity, low pressure and high compliant reservoir but these characteristics also are increased with time.