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Objective: Description of the results of using the Y (Fontana) pouch ileal neobladder for reconstruction after radical cystectomy in a subset of patients in the national cancer institute of Cairo university in Egypt in terms of operative time, post-operative complications, urodynamic studies and patient satisfaction.
Methods: In 2014, A prospective interventional study was carried out in the National Cancer Institute involving 29 patients with bladder cancer who met the criteria for neobladder reconstruction after radical cystectomy for whom a modified Y shaped ileal neobladder was created after tumor exanteration aiming at exploring the operative time, complications and patient satisfaction rates for a period of one year in such a group of patients compared to other reconstructive options. Complications were assessed per the Clavien-Dindo classification system(CDC).
Results: The mean time to create the Y pouch ileal neobladder was 34 minutes. Early complications were reported in 14 patients (48%) with a highest CDC grade of III while late complications (after 30 days) were reported in 17 patients (58%) with a highest CDC grade of V (three patients died during the follow up course). The mean value of maximum neobladder capacity was 445ml, the mean pressure at maximum neobladder capacity was 22cmH2O and the mean post-voiding urine residual was about 20ml. By 6 months' post operatively, about 85% of the cases expressed having a good quality of life evidenced by satisfaction about their body image, daily maintenance and general satisfaction.
Conclusion: Orthotopic neobladder reconstruction using the Y (Fontana) ileal neobladder can be considered as a simple and practical solution for neobladder reconstruction after radical cystectomy in Egyptian bladder cancer patients.
