Stone formation in Padua Ileal Neobladder performed with stapler
INTRODUCTION AND OBJECTIVES: The increasing trend in performing radical cystectomy (RC) in a minimally invasive approach made stapled neobladders a popular alternative to hand-sewn pouches. To date, the incidence and the clinical impact of stone formations in long-term survival patients after neobladders has not been addressed.
In this paper we assessed the risk of stone formation in a single-center cohort of 445 consecutive patients who underwent open RC and stapled orthotopic ileal neobladders.
METHODS: From May 2001 and October 2012, 445 consecutive patients, 388 males and 57 females, were treated with RC and orthotopic Padua ileal neobladder.
All neobladders were performed with stapler.
Univariable analysis was performed to identify variables predicting an increased risk of stone formation.
RESULTS: Median follow up was 41 (IQR 16-58) months. Neobladder stones occurred in 41 patients (9.2%) at a median time of 30 (IQR 15-44) months.
All these patients successfully underwent endoscopic stone lithotripsy, 34 of which as outpatient procedure.
At univariable analysis only female gender was associated with an increased risk of stone formation (p=0.007).
CONCLUSIONS: In our series of “stapled” Padua ileal neobladder, the rate of stone formation was comparable with that reported in literature for completely hand sewn ileal reservoirs.
Our findings need to be confirmed by prospective randomized trials.