Y-neobladder: an easy, fast, and reliable procedure

Urology. 2004 Apr;63(4):699-703. doi: 10.1016/j.urology.2003.11.015.


Objectives: To describe the operative technique of a new, Y-shaped, ileal neobladder and report the clinical and functional outcomes to add a contribution to the most discussed issues about orthotopic neobladders, in particular related to the problem of the prevention of strictures of ureteral-neobladder anastomoses.

Methods: Between January 1999 and June 2002, 50 patients (41 men and 9 women) underwent radical cystectomy and Y-shaped orthotopic neobladder reconstruction. The following parameters were considered: operative time, complications, and functional outcomes (evaluated with voiding chart and a questionnaire analyzing continence). Urodynamic studies were performed in the first 20 patients.

Results: The operative time for neobladder reconstruction was 15 to 20 minutes. No severe complications or significant metabolic complications were recorded. Only 1 case of unilateral stricture of the ureteral-neobladder anastomosis was recorded (1% of renal units); the stricture was easily treated with a retrograde endoscopic approach. Daytime and nighttime continence was good or satisfactory in 90% and 85% of patients, respectively. One year after surgery, the average maximal neobladder capacity was 390 mL, and the average pressure at maximal capacity was 15 cm H2O.

Conclusions: The ileal Y-shaped orthotopic neobladder had good functional outcomes comparable to most popular orthotopic neobladders. Moreover, the surgical technique of the Y-neobladder is easy, rapid, and reliable. In particular, the Y-neobladder seemed to reduce, in our experience, the occurrence of strictures at the ureteral-neobladder anastomosis, because it permits a perfectly aligned anastomosis without mobilization of the ureters.

MeSH terms

  • Aged
  • Anastomosis, Surgical / methods
  • Cystectomy
  • Female
  • Humans
  • Ileum / surgery*
  • Male
  • Middle Aged
  • Postoperative Complications / prevention & control
  • Treatment Outcome
  • Ureteral Obstruction / prevention & control
  • Urinary Bladder Neoplasms / surgery
  • Urinary Diversion / methods*
  • Urinary Reservoirs, Continent*
  • Urodynamics / physiology
  • Urologic Surgical Procedures / methods*