Urethral controlled bladder substitution: A comparison between the intussuscepted nipple valve and the technique of Le Duc as antireflux procedures

A. A. Shaaban, M. A. Gaballah, T. A. El-Diasty, M. A. Ghoneim, Arthur I Sagalowsky, D. G. Skinner

Research output: Contribution to journalArticle

59 Scopus citations

Abstract

A urethral controlled bladder substitute was constructed from a detubularized, double folded ileal segment in 40 male patients following cystoprostatectomy for bladder cancer. For reflux prevention patients were prospectively randomized to receive either an intussuscepted nipple valve or the ureters were implanted by the Le Duc mucosal trough technique. All patients had normal upper tracts preoperatively. Mean patient age, performance status and stage of cancer were comparable in both groups. Patients were evaluated 6 to 18 months postoperatively. In addition to history taking, assessment included excretory urography, ascending cystography and voiding cystourethrography. During the observation period all patients with nipple valves had normal radiographic appearance of the upper tracts without evidence of reflux. On the other hand, following the Le Duc procedure 12 of 38 renal units (31%) showed evidence of radiographic dilatation. Of the 12 units 11 had stenotic ureters and 1 had reflux. We conclude that nipple valves are more effective in reflux prevention and protection of the upper urinary tract in patients for whom an ileal neobladder is indicated.

Original languageEnglish (US)
Pages (from-to)1156-1161
Number of pages6
JournalJournal of Urology
Volume148
Issue number4
DOIs
StatePublished - Jan 1 1992

Keywords

  • ileum
  • urinary diversion
  • vesico-ureteral reflux

ASJC Scopus subject areas

  • Urology

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