الفهرس 
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Abstract
Dissertation Abstract : Background: Surgery performed to improve or region the function of the diseased urinary bladder has evolved throughout the last century. The main reasons for improving or replacing the function of the urinary bladder are bladder cancer, neurogenic bladder dysfunction, refractory overactive bladder (OAB), and chronic inflammatory diseases of the bladder (such as IC, TB). However, there is still much uncertainty about the best surgical approach. Aim of the work: We evaluate long-term functional outcomes in patients with continent urinary diversion. They were divided into three groups, group I (Augmentation ileocystoplasty), group II (Orthotopic Neobladder), and group III (Continent Cutaneous Outlet) in patients with benign disorders. Patients and Methods : This is a Non-concurrent cohort study. All patients from 1990 to 2016 will be retrospectively reviewed. Patients who underwent augmentation cystoplasty with or without CCO, and who underwent simple cystectomy with orthotopic diversion for benign diseases. Completed at least 36 months of follow-up. The primary outcome is to evaluate the long-term renal functional outcomes. The secondary outcome is the quality of life of each treatment group and compares long-term complications. Results : Of all 113 patients, 46 (41%) received an AC, 10 (9%) received an ONB, and 57 (50%) received a CCO. The mean age in group I, II, and III are 34.1, 48.4, and 17.2 years, respectively. The primary outcome evaluates the renal parameters. The estimated GFR shows a significant difference between the three groups with P-value<0.010, the Mean ± SD in group I, group II, group III are 98 ± 46, 72 ± 24.8, and 120.7 ± 51.4 respectively. In group III, 7 cases (13%) complained of reservoir stones, while only 1 case (10%) was in group II, and in group I, 2 cases (4%) only. One case in group I and group II suffered from PN. Metabolic changes occurred in 2 cases in group I and 3 cases in group II and III. One case in group III suffered from perforation. In group III, 7 cases suffered from a stenosed outlet. In group III, two cases suffered from incontinence because of the opened bladder neck. In group III, 8 cases suffered from incontinence from the outlet, 4 cases were treated by open revision of the outlet, and the others managed conservatively. The incidence of incontinence with the need of bad is higher in group III than in group I and II. Using a multivariate analysis, pre-GFR is the only variable with OR (95% CI)=1.020 (1.002-1.039), with a significant P-value = 0.029. CISC does not reach a significant value OR (95% CI)=0.063 (0.003-1.320), with a insignificant P-value = 0.075. Conclusion: Long-term complications are comparable between the three groups. The QOL is slightly worst in group III. Renal function outcome is affected significantly by pre glomerular filtration rate, and nearly significant to CISC. Recommendations: more prospective studies with a larger number of patients are needed.