Colposuspension using polypropylene tape in patients with orthotopic ileal bladder – functional results
Article published in Urologia Polska 2008/61/Supl. 1.

authors

Marcin Życzkowski, Andrzej Paradysz, Maciej Szczębara, Mieczysław Fryczkowski

Katedra i Klinika Urologii w Zabrzu Śląskiego Uniwersytetu Medycznego w Katowicach

summary

Introduction.

Colposuspension is usually used, with good results, in case of descensus of uterus. Using this method for reinforcement of pelvic floor seems to be also useful in women after cystectomy and orthotopic ileal bladder creation.

Objectives.

Initial evaluation of efficacy of polypropylene tape colposuspension in obtaining continence in patients after radical cystectomy and orthotopic ileal bladder creation.

Materials and methods.

In 3 female patients aged 48-57 years old (mean – 52,3 years old), during cystectomy with ileal bladder creation, colposuspension to promotorium was performed using 3 cm wide tape made of polypropylene surgical net Dallop PP TDM KTM. In all these cases radical cystectomy was performed due to muscle-invasive bladder cancer, staged: pT3aN1M0 G3, pT3aN0M0 G2 and pT2bN0M0 G2. In all 3 patients orthotopic ileal bladder was created using Studer method. 2 patients underwent adiuvant chemotherapy. Patients are still under strict control, including urine continence control based on coughing test and one hour inlay test. Observation time is from 3 to 24 months (mean – 11 months). Control CT scans did not reveal progression.

Results.

2 patients observe subjectively full continence, 1 of them reports sometimes low grade incontinence. In all patients coughing test and one hour inlay test is negative.

Conclusions.

1.Fixation of vagina stump to promotorium is simple method leading to its stabilization and reinforcement for new-formed bladder neck. 2. There is possible that this mechanism, besides gentle preparing of urethral sphincter surroundings, significantly leads to continence improvement. 3. Colposuspension in patients after cystectomy with orthotopic ileal bladder is valuable supplement to former methods leading to continence. 4. Presenting method requires further observations and investigations based on greater number of cases.