الفهرس 
Introduction Aim of workOnly 14 pages are availabe for public view
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Abstract
Objective: Long-term analysis; in a retrospective fashion; of the functional outcome following orthotopic ileal w-neobladder with serous-lined extramural ureterointestional implantation to verify the durability of this technique. Patients and Methods: Between December 1999 and December 2001, 667 patients with invasive bladder tumor underwent radical cystectomy and orthotopic ileal w- neobladder. They were evaluated by history taking clinical examination, serum creatinine, sodium, potassium, Acid-base profile, urine culture and different methods of imaging for upper tract assessment, reflux evaluation and pouch evaluation. Results: Evaluable patients were 407, 315 males and 92 females. Postoperative mortality was 1.6%. Early complications were 15%. Late complications were 9%. Day time continence was 94% and 90.3% in males and females respectively. Night time continence was 76.5% and 80.4% in males and females respectively. Diurnal and nocturnal frequency was acceptable in both males and females. The upper tract was stable or improved in 94% of renal units with classic ileal w-neobladder and in 88% of renal units with modified ileal w-neobladder. Reflux was observed in 4.5% of renal units with classic ileal w-neobladder and in 30% of renal units with modified ileal w-neobladder. Bacterial colonization was detected in 34.1% of patients. Serum creatinine was stable or improved in 98% of patients. Serum sodium and potassium were normal in all patients. Subclinical metabolic acidosis was detected in 18% of patients. Conclusion: Serous-lined extramural antireflux mechanism is simple, durable, reproducible, versatile, has a low complication rate and can adapt itself for different reservoirs.