Yeni mesane yapılan hastalarda yeni mesanenin yarattığı sorunlar ve bunlara yaklaşım

  • Ali İhsan Arık
  • Cemil Uygur

Bull Urooncol 2010;9(1):49-56

At most centres with experience in urinary diversion, an orthotopic urinary reservoir is the diversion of choice after radical cystectomy for bladder cancer. Any patient who is to undergo a radical cystectomy for bladder cancer is a potential candidate for orthotopic diversion provided they do not have chronic renal insufficiency. In addition, they must have a negative urethral margin at the time of cystectomy, and have the mental and physical capacity to understand what is required to manage the reservoir after surgery. Proper patient selection is the key to success. Notably, chronologic age is not an absolute contraindication to orthotopic diversion. Instead, careful consideration of the patient's comorbid conditions should guide eligibility. In addition, locally advanced disease is not a contraindication to an orthotopic diversion. Cystectomy followed by orthotopic neobladder is a time consuming and tiring operation. It has the potential of significant rate of early and late complications. Metabolic complications following continent urinary diversion are common. Careful patient selection and vigilant followup are essential for good long-term results in patients undergoing continent urinary diversion. Both the operating team and the physicians responsible for he follow-up of these patients should be aware and experienced in the solutions of the problems that these patients may encounter.