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European Urology

European Urology

Volume 50, issue 2, pages 175-394, August 2006

Surgery in Motion

Radical Cystectomy and Orthotopic Bladder Replacement in Females

Udo Nagele, Markus Kuczyk, Aristotelis G. Anastasiadis, Karl-Dietrich Sievert, Jörg Seibold and Arnulf Stenzl

Accepted 3 May 2006, Published online 21 June 2006, pages 249 - 257


Abstract

Introduction

More than 15 years ago, several centers started to offer urethra-sparing cystectomy and orthotopic urinary diversion for female patients with bladder malignancies. Several studies have been published, outlining both the anatomical and oncological aspects of such an approach.

Methods

In this contribution, the main aspects regarding the surgical technique of cystectomy and orthotopic urinary diversion in female patients, including technical variations which have been derived over the years, are presented.

Results and Conclusion

The video shows a detailed description of the surgical technique, and the main steps of the procedure are demonstrated in schematic drawings as well as in animations to facilitate understanding. Emphasis is given on important anatomical and physiological aspects, which have influenced the current surgical steps. Possible sequelae on oncological and functional outcome, which play an important role in the evaluation of this procedure, are also discussed.

Keywords: Cystectomy, Neobladder, Urinary diversion, Bladder substitute, Female patient.


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