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Abstract
The aim of this study is to evaluate the early metabolic and
pathologic consequences, and the structural changes of the ileal
neobladder mucosa, in patients who underwent radical cystectomy and
urinary diversion with orthotopic ileal neobladder. The indications for continent urinary diversion and reconstruction using intestinal segments have expanded greatly, including benign and malignant conditions in children and adults. Bowel was not meant to serve
as a container for urine, so the use to which it is put in urology may result in numerous complications, from the clinically irrelevant to the life-
threatening. Orthotopic ileal neobladder substitution is a well accepted form of urinary diversion however, potential metabolic consequences in the early
postoperative period as well as long-term remain a serious problem. Between June 2003 and October 2004, 25 patients underwent continent urinary diversion with orthotopic ileal neobladder after radical cystectomy at Urology Department in Zagazig University Hospitals. Invasive bladder cancer was the indication in an cases. W -shaped orthotopic ileal neobladder was used. from our study we could conclude thai artificially combining two extremely different organ systems after orthotopic ileal neobladder diversion for malignant bladder disease requires meticulous follow-up. Acid-base status should be monitored regularly, particularly in the early postoperative period. One should have high index of suspicion if patients have nonspecific illness. Acidosis and electrolyte disturbance should be excluded early. Also, morphological changes in the ileal neobladders have practical importance because the histological modifications may alter the functional characteristics of the mucosa; particularly in absorption with subsequent decreased risk of metabolic alterations, or they may cause new pathology (i.e. malignancies) secondary to the modifications. The ileal mucosa in the substitute bladder apparently adapted well to the new environment; i.e. urine retention and bladder expansion and contraction.