Computed Tomographic Appearance of Orthotopic Neobladder: Correlation with Voiding Pattern.
- Author:
Ji Youl LEE
1
;
Sae Woong KIM
;
Wang Jin PARK
;
Kee Uk CHUNG
;
Seung Ju LEE
;
Seung Eun JUNG
;
Yong Hyun CHO
;
Moon Soo YOON
Author Information
1. Department of Urology, The Catholic University Medical College, Seoul, Korea. ksw1227@cmc.cuk.ac.kr
- Publication Type:Original Article
- Keywords:
Bladder cancer;
Orthotopic bladder substitution;
Computed tomography;
Neobladder
- MeSH:
Cystectomy;
Humans;
Male;
Urinary Bladder;
Urinary Bladder Neoplasms
- From:Korean Journal of Urology
2001;42(11):1140-1145
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To define computed tomographic (CT) appearance according to voiding patterns and to evaluate the significance of CT in patients with voiding dysfunction after orthotopic bladder substitution following radical cystectomy. MATERIALS AND METHODS: We evaluated a total of 50 male patients in whom 25 had undergone an ileocolic and 25 had undergone an ileal neobladder. We performed uroflowmetry, postoperative voiding cystourethrography (VCUG) and CT for evaluation of configuration of neobladder according to voiding pattern. We defined a good voider (n=37) as the patients with maximum flow rate greater than 15 ml/sec and postvoid residual urine amount less than 200ml and a poor voider (n=13) as those with less than 15 ml/sec or greater than 200ml. RESULTS: Voiding cystourethrography revealed that the neobladder outlet was well funneled and wide open at the most dependent portion of the neobladder in good voider group. However, in poor voider group, the neobladder outlet was not funneled or deviated from its caudal location. CT revealed that the neobladder was symmetric in 28 cases (75.7%) and had soft tissue density in the neobladder base in 9 cases (24.3%) of good voider group. However, neobladder was asymmetric in 8 cases (61.5%) and had soft tissue density in the neobladder base in 8 cases (61.5%) of poor voider group. CONCLUSIONS: The asymmetry of neobladder and soft tissue density around base of neobladder on CT may be associated with the deviated neobladder outlet. This CT finding might be useful to presume the cause of voiding pattern.
