الفهرس 
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Abstract
Urinary bladder cancer is a common disease worldwide. Urinary
bladder cancer ranks ninth in the worldwide cancer incidence
(Ferlay et al., 2004). It is the seventh most common malignancy in men
and seventeenth in women. Urinary bladder cancer is the second most
common malignancy of all genitourinary tumors after prostate cancer and
is nearly three times more common in men than in women (Jemal et al.,
2005).
Radical cystectomy is the standard treatment for patients with
invasive bladder cancer and for those with superficial bladder cancer who
did not respond to intravesical therapy (Cheryl et al., 2006-Solsona et
al., 2003).
This study aims at evaluation of long-term outcomes, both
functional and oncological, in patients treated with radical cystectomy
and different types of diversion for invasive bladder cancer.
This retrospective study was conducted in Kasr EL- Aini hospitals
and Students’ Hospital, between June 2009 and December 2010. The
study included 65 patients, 51 males and 14 females, whom underwent
radical cystectomy for bladder malignancy with different types of
diversions (ileal neobladder, ileal coduit, ureterocolic, ureterocutaneous)
Follow-up was done starting 6 months after operation and every 3 months
(9 and 12 months), for older patients follow up was done at the time of
their attendance at the outpatient clinic.
Summary
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Results: Erectile dysfunction developed post-operatively in 41
males (80.4%) in non nerve sparing cystectomy, Nocturnal incontinence
41%, Stress incontinence 4.5%, Urge incontinence 4.5%, Total
incontinence2.27% while 21 patients (47.7%) were continent day and
night, Stones developed post-operatively in 2 patients (3.1%), Stomal
stenosis developed in 2 patients (12.5% of stomas), Incisional hernia
developed in 2 patients (3.1%), Ureteric stricture in 2 patients (3.1%),,
Rediversion was done in one patient (1.5%), Recurrent UTI was recorded
in 19 cases (29.2% ) 10 cases of orthotopic diversion, 5 cases of
ureterocolic, 3 cases of ureterocutaneous and one case of ileal conduit,
Uraemia & Dialysis in15.4% of cases, Metastasis was recorded as
follows (Local 1.5%, Distant 18.5% and both 3.1%) and Mortality 24.6%.
.
Conclusion: Long term follow-up for patients with radical
cystectomy and urinary diversion shows high complication and high
surgical re-intervention rates. Longer follow-up period for years is needed
for radical cystectomy with urinary diversion techniques to verify causes
and prevent complications.
References