ABSTRACT
After detubularization of the segments, pressures of a right colonic reservoir do not exceed 40 cmH2O, which is of importance regarding continence and reflux.15,16
If preservation of the urethra is indicated in cystoprostatectomy in males or cystectomy in females,
orthotopic bladder substitution is an option. As in all other orthotopic bladder substitutes, the right colon or ileocecal bladder substitution is indicated in cases of bladder cancer not involving the prostatic urethra and the urethral stump, which is determined by preoperative biopsies from the prostatic urethra at the time of transuretheral resection of bladder tumors and by frozen sections from the urethral stump taken during radical cystectomy. In case of benign indications (interstitial cystitis, low compliance bladders, detrusor hyperreflexia), bladder substitution using ileocecal or colon segments can be performed to the bladder neck or to the trigone depending on the necessity of ureteral reimplantation as determined by the presence of vesicoureteral reflux or obstruction.
