Objective: To evaluate and compare the urodynamic parameters and continence rate of urine reservoir function among patients who had undergone orthotopic bladder substitution with sigmoid or ileal segments. Methods: Continent urinary reservoirs were constructed in 73 patients. Thirty-three patients were received a sigmoid neobladder ( SN) and 40 patients with an ileal neobladder (IN). All patients were examined urodynamically and taken intravenous pyelography to test their continence status. Urodynamic parameters and continence were obtained. Results: Complete follow-up was performed in 73 cases 12 months averagely postoperatively. The patients were examined after 3-6 months. There was no perioperative fatality cases. The average reservoir capacity of IN(485 ± 60) ml was higher than of SN(350 ±52) ml(P 0. 05 ) . Two cases of hydronephrosis with mild impaired renal function were found in SN. Conclusions: A neobladder constructed from detubularized ileum or sigmoid achieves adequate reservoir capacity,accepted urodynamics with a satisfactory daytime continence rate. Nighttime incontinence in patients with IN and SN is still a vexed problem.%目的:评价原位回肠新膀胱(IN)与乙状结肠新膀胱(SN)术后早期贮尿囊功能状态.方法:73例膀胱移行细胞癌患者行根治性膀胱全切术和肠道原位新膀胱术,其中行IN 40例,行SN 33例.采用影像学、尿流动力学检查和控尿状态评估早期新膀胱的功能.结果:73例平均随访12个月,无围手术期病死病例.术后3～6个月,IN组最大贮尿量为(485±60) ml,较SN组的(350±52) ml多(P0.05).SN组出现2例上尿路轻度积水,肾功能轻度受损.结论:采用去管化的回肠或乙状结肠重建新膀胱能达到足够的贮尿容量和可接受的尿动力学改变,获得满意的日间控尿.SN夜间控尿较IN差.夜间尿失禁仍是肠道膀胱替代术所面临的问题.
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