[Orthotopic reconstruction of the urinary bladder with preservation of urethral function in women after cystectomy].

Since 1993 till 1995 cystectomy preserving the urethra in twelve female patients with infiltrating bladder cancer was performed. The patients age ranged form 32 to 72 years. The female urethra sparing radical cystectomy includes removal of the bladder together with the uterus and ovaries and resection of the anterior vaginal wall. The condition for preserving of the function of the urethra is its integrity including corresponding innervation and intact pelvic floor. The neobladder is made of a detubularized ileal segment and anastomosed with the urethra. Diurnal continence was achieved in 11 patients, one of them has so called hypercontinence with residual volume of 300 ml. One patient suffers from stress incontinence. The functional characteristics of the orthotopic neobladder in the operated females are very favourable. The risk of further affliction of the retained urethra with an urothelial tumor is possible to influence by a choice of selected patients for the overmentioned procedure.