Objective   To compare the clinical outcome and complications of stomachal orthotopic neobladder and ileal orthotopic neobladder.    Methods   We retrospectively reviewed the medical records

laboratory evaluations

imaging examination

cystoscopy

urodynamic studies of 84 bladder cancer patients who had under

gone total cystectomy in our department during March 2001 to May 2008. Among them

there were 44 cases of substitution of wedge-shaped stomach for urinary bladder

and 40 cases of substitution of ileum for urinary bladder. All the 84 patients were followed up for 4 to 78 months.    Results   These patients  micturated through the urethra. There was no disturbance of water and electrolyte metabolism

no hydronephrosis and  ureterectasis

no uracratia

and no damage to renal function. In the patients with stomachal neobladder

the bladder capacity was 290 to 530 ml (mean 395 ml)

the urination interval was 2 to 4.8 h (mean 3.2 h)

the maximal flow rate was 12.8 to 26.2 ml/s (mean 18.4 ml/s)

and the filling bladder pressure was 5 to 15 cmH

2

O (mean 10 cmH

2

O). The residual urine was 10 to 110 ml (mean 36 ml)

and the pH value of urine was 4.5 to 6.7 (mean 5.8). All of the 44 cases achieved continence during daytime

and 8 cases who developed enuresis had urethralgia. Urinary tract infections occurred in 13 cases. Postoperative cystoscopy showed that gastrocystic mucosa was even and smooth in white color without ulcer. While

in the patients with ileal neobladder

the bladder capacity was 350 to 550 ml (mean 426 ml)

the urination interval was 2 to 4.6 h (mean 3.4 h)

the maximal flow rate was 13.5 to 26 ml/s (mean 18.8 ml/s)

and the filling bladder pressure was 6 to 15 cmH

2

O (mean 10 cmH

2

O). The residual urine was 10 to 150 ml (mean 40 ml)

and the pH value of urine was 6.0 to 7.2 (mean 6.5). All of the 40 cases achieved continence during daytime

and 5 cases were incontinent at night. Urinary tract infections occurred in 35 cases

and among them

upper urinary tract infections occurred in 4 cases who had a high fever. Postoperative cystoscopy showed that ileal neobladder mucosa was even and smooth in white color without ulcer

and there was much mucus in the neobladder.    Conclusion   Filling function and continence status of stomachal or ileal orthotopic neobladder are

satisfactory after radical cystectomy. Our results show that there is significant increase in risk of urinary tract infection occurring in the patients with ileal neobladder. In the patients with stomachal neobladder

one of common complications is urethralgia

but it doesn’t occur in the patients with ileal neobladder.