Skip to main content
SpringerLink
Log in

Current Concepts for Urinary Diversion in Women

  • Chapter
Bladder Cancer

Part of the book series: Current Clinical Urology ((CCU))

  • 136 Accesses

Abstract

Although intestinal continent reservoirs to the urethra have been used now successfully in the male for several years (1,2) its use in females undergoing cystectomy for bladder cancer has not routinely been considered till recently. An undefined risk of the extent of transitional cell cancer (the most common type of bladder cancer) into the female urethra was probably the reason for almost unequivocally performing total urethrectomy in combination with anterior pelvic exenteration. The lack of a remnant portion of the urethra, no data about secondary urethral tumors, and insufficient knowledge about the functional anatomy of the isolated female urethra and its sphincter were the biggest obstacles in the development and common use of an orthotopic reconstruction of the lower urinary tract after cystectomy for bladder cancer. The use of intestinal pouches with ileal segments as a urethral substitute with or without an artificial urinary sphincter had not gained wide acceptance either (3).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Skinner DG, Boyd SD, Lieskovsky G, Bennett C, Hopwood B. Lower urinary tract reconstruction following cystectomy: experience and results in 126 patients using the Kock ileal reservoir with bilateral ureteroileal urethrostomy. J Urol 1991; 146: 756–760.

    CAS  PubMed  Google Scholar 

  2. Studer UE, Danuser H, Merz VW, Springer JP, Zingg EJ. Experience in 100 patients with an ileal low pressure bladder substitute combined with an afferent tubular isoperistaltic segment. J Urol 1995; 154: 49–56.

    Article  CAS  PubMed  Google Scholar 

  3. Light K. Long term results using the artificial sphincter around bowel. Br J Urol 1989; 64: 56.

    Article  CAS  PubMed  Google Scholar 

  4. Pawlick K. Exstirpace mechyre mocoveho. Lekaru Ceskych, 1890; xxix: 705–706.

    Google Scholar 

  5. Lotheissen G. Ueber Uretertransplantationen. Wiener Klin Wochenschrift 1899; 12: 883–889.

    Google Scholar 

  6. Coffey R. Physiologic implantation of the severed ureter or common bile duct into the intestine. JAMA 1911; 56: 397–401.

    Article  Google Scholar 

  7. Skinner DG, Studer UE, Okada K, Aso Y, Hautmann H, Koontz W, et al. Which patients are suitable for continent diversion or bladder substitution following cystectomy or other definitive local treatment? Int J Urol 1995; 2: 105–112.

    Article  PubMed  Google Scholar 

  8. Cancrini A, de Carli P, Fattahi H, Pompeo V, Cantiani R, von Heland M. Orthotopic ileal neobladder in female patients after radical cystectomy: 2-year experience. J Urol 1994; 153: 956–958.

    Article  Google Scholar 

  9. Tobisu K-I, Coloby P, Fujimoto H, Miutani T, Kakizoe T. An ileal neobladder for a female patient after radical cystectomy to ensure voiding from the urethra: a case report. Jpn J Clin Oncol 1992; 22: 359–363.

    CAS  PubMed  Google Scholar 

  10. Stein J, Stenzl A, Esrig D, Freeman J, Boyd S, Lieskovsky G, et al. Lower urinary tract reconstruction following cystectomy in women using the Kock ileal reservoir with bilateral ureteroileal urethrostomy: initial clinical experience. J Urol 1994; 152: 1404–1408.

    CAS  PubMed  Google Scholar 

  11. Coloby P, Kakizoe T, Tobisu K-I, Sakamoto M. Urethral involvement in female bladder cancer patients: mapping of 47 consecutive cysto-urethrectomy specimens. J Urol 1994; 152: 1438–1442.

    CAS  PubMed  Google Scholar 

  12. Stein J, Cote R, Freeman J, Esrig D, Skinner E, Boyd S, et al. Lower urinary tract reconstruction in women following cystectomy for pelvic malignancy: a pathologic review of female cystectomy specimens. J Urol 1994; 151: 304A, abstract 308.

    Google Scholar 

  13. Stenzl A, Draxl H, Posch B, Colleselli K, Falk M, Bartsch G. The risk of urethral tumors in female bladder cancer: can the urethra be used for orthotopic reconstruction of the lower urinary tract? J Urol 1995; 153: 950–955.

    Article  CAS  PubMed  Google Scholar 

  14. Colleselli K, Stenzl A, Eder R, Strasser H, Poisel S, Bartsch G. The female urethral sphincter: a morphological and topographical study. J Urol 1998; 160: 49–54.

    Article  CAS  PubMed  Google Scholar 

  15. Stenzl A, Colleselli K, Poisel S, Feichtinger H, Pontasch H, Bartsch G. Rationale and technique of nerve sparing radical cystectomy before an orthotopic neobladder procedure in women. J Urol 1995; 154: 2044–2049, © Springer-Verlag GmbH and Co. KG, Germany.

    Google Scholar 

  16. Stenzl A, Colleselli K, Bartsch G. Update of urethra-sparing approaches in cystectomy in women. World J Urol 1997; 15: 134–138.

    Article  CAS  PubMed  Google Scholar 

  17. Stenzl A, Colleselli K, Poisel S, Feichtinger H, Bartsch G. The use of neobladders in women undergoing cystectomy for transitional-cell cancer. World J Urol 1996; 14: 15–21.

    Article  CAS  PubMed  Google Scholar 

  18. Hautmann R, Paiss T, Kleinschmidt K, de Petriconi R. The ileal neobladder in the female: why it works or not. J Urol 1995; 153: 243A, abstract 58.

    Google Scholar 

  19. Jarolim L, Babjuk M, Hanus T, Jansky M, Skrivanova V. Female urethra-sparing cystectomy and orthotopic bladder replacement. Eur Urol 1997; 31: 173–177.

    CAS  PubMed  Google Scholar 

  20. Stein JP, Grossfeld GD, Freeman JA, Esrig D, Ginsberg DA, Cote RJ, et al. Orthotopic lower urinary tract reconstruction in women using the Kock ileal neobladder: updated experience in 34 patients. J Urol 1997; 158: 400–405.

    Article  CAS  PubMed  Google Scholar 

  21. Stenzl A, Colleselli K, Poisel S, Feichtinger H, Bartsch G. Anterior exenteration with subsequent ureteroileal urethrostomy in females. Anatomy, risk of urethral recurrence, surgical technique, and results. Eur Urol 1998; 33: 18–20.

    Article  PubMed  Google Scholar 

  22. Stenzl A, Draxl H, Posch B, Colleselli K, Falk M, Bartsch G. The risk of urethral tumors in female bladder cancer: can the urethra be used for orthotopic reconstruction of the lower urinary tract? J Urol 1995; 153: 950–955 issn: 0022–5347.

    Google Scholar 

  23. Packham D. The epithelial lining of the female trigone and urethra. Br J Urol 1971; 43: 201.

    Article  CAS  PubMed  Google Scholar 

  24. Wiener D, Koss L, Salaby B, Freed S. The prevalence and significance of Brunn’s nests, cystitis cystica, and squamous metaplasia in normal bladders. J Urol 1979; 122: 317.

    CAS  PubMed  Google Scholar 

  25. De Paepe M, André R, Mahadevia P. Urethral involvement in female patients with bladder cancer. A study of 22 cystectomy specimens. Cancer 1990; 65: 1237–1242.

    Article  PubMed  Google Scholar 

  26. Ashworth A. Papillomatosis of the urethra. Br J Urol 1956; 28: 3–11.

    Article  CAS  PubMed  Google Scholar 

  27. Erckert M, Stenzl A, Falk M, Bartsch G. The incidence of urethral tumor involvement in male bladder cancer patients. World J Urol 1996; 14; 3–8.

    Article  CAS  PubMed  Google Scholar 

  28. Hautmann RE. Neobladder and bladder replacement. Eur Urol 1998; 33: 512.

    Article  Google Scholar 

  29. Studer UE, Danuser H, Hochreiter W, Springer JP, Turner WH, Zingg EJ. Summary of 10 years’ experience with an ileal low-pressure bladder substitute combined with an afferent tubular isoperistaltic segment. World J Urol 1996; 14: 29–39.

    Article  CAS  PubMed  Google Scholar 

  30. Iselin CE, Robertson CN, Webster GD, Vieweg J, Paulson DF. Does prostate transitional cell carcinoma preclude orthotopic bladder reconstruction after radical cystoprostatectomy for bladder cancer? J Urol 1997; 158: 2123–2126.

    Article  CAS  PubMed  Google Scholar 

  31. Wein A, Levin R, Barrett D. Voiding function: relevant anatomy, physiology, and pharmacology. In: Adult and Pediatric Urology (Gillenwater J, Grayhack J, Howards S, Duckett J, eds.) 2nd ed, Chicago, IL, Year Book, 1991, pp. 933–999.

    Google Scholar 

  32. Gosling JA, Dixon JS, Critchley HO, Thompson SA. A comparative study of the human external sphincter and periurethral levator ani muscles. Br J Urol 1981; 53: 35–41.

    Article  CAS  PubMed  Google Scholar 

  33. Tanagho EA, Meyers FH, Smith DR. Urethral resistance: its components and implications. II. Striated muscle component. Invest Urol 1969; 7: 195–205.

    CAS  PubMed  Google Scholar 

  34. Donker P, Droes J, Van Ulden B. Anatomy of the musculature and innervation of the bladder and the urethra. In: Scientific Foundations of Urology (Williams D, Chisthol G, eds.). Heinemann, London, 32. vol I I, 1976.

    Google Scholar 

  35. Neuwirth H, Stenzl A, de Kernion J. Urethral cancer. In: Cancer Treatment ( Haskell C, ed.). WB Saunders, Philadelphia, PA, 1990, pp. 762–764.

    Google Scholar 

  36. Spence H, Duckett J. Diverticulum of the female urethra: clinical aspects and presentation of a simple operative technique for cure. J Urol 1970; 104: 432.

    CAS  PubMed  Google Scholar 

  37. Reiffenstuhl G. Das Lymphsystem des weiblichen Genitale. Urban and Schwarzenberg, Munich, 1957.

    Google Scholar 

  38. Stein JP, Lieskovsky G, Ginsberg DA, Bochner BH, Skinner DG. The T pouch: an orthotopic ileal neobladder incorporating a serosal lined ileal antireflux technique. J Urol 1998; 159: 1836–1842.

    Article  CAS  PubMed  Google Scholar 

  39. Studer U, Ackermann D, Casanova G, Zingg E. Three year’s experience with an ileal low pressure bladder substitute. Br J Urol 1989; 63: 43–52.

    Article  CAS  PubMed  Google Scholar 

Download references

Authors
  1. Arnulf Stenzl MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Georg Bartsch MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Urology, Mount Sinai School of Medicine, New York, NY, USA

    Michael J. Droller MD

Rights and permissions

Reprints and permissions

Copyright information

© 2001 Springer Science+Business Media New York

About this chapter

Cite this chapter

Stenzl, A., Bartsch, G. (2001). Current Concepts for Urinary Diversion in Women. In: Droller, M.J. (eds) Bladder Cancer. Current Clinical Urology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-097-1_14

Download citation

  • DOI: https://doi.org/10.1007/978-1-59259-097-1_14

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-61737-202-5

  • Online ISBN: 978-1-59259-097-1

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation