PURPOSE:Orthotopic ileal bladder substitution is a well accepted form of urinary diversion providing high quality of life. However, potential metabolic consequences remain a serious problem. These complications are discussed in the present article.MATERIAL AND METHODS:Authors review the metabolic complications of 45 orthotopic ileal neobladder cases.RESULTS:Insufficient absorption (malabsorption) associated with ileal resection is quite rare, while hyperchloremic metabolic acidosis after ileal neobladder is a rather common phenomenon (55%).CONCLUSION:Authors suggest careful patient selection, correct operative technique and vigilant follow-up for successful treatment of metabolic complications.

PURPOSE:This is a retrospective study comparing the clinical data and morbidity of transperitoneal radical nephrectomy (TRN) and simple nephrectomy.MATERIAL AND METHODS:From 1st January, 1989 to 1st January, 1996 a total of 90 simple nephrectomies and from 1st January, 1996 to 1st August, 1999 a number of 85 TRN were performed at the Department of Urology of the Saint Stephen Hospital. The analysis of clinical data included operative time, length of analgesics, postoperative hospital stay and blood loss, as well as morbidity.RESULTS:The mean operative time for TRN was 170 min., being 95 min. for simple nephrectomy. The mean blood loss for TRN was 250 ml, and 400 ml for simple nephrectomy. There were different types of morbidity for TRN and simple nephrectomy. The complications of TRN mean minimal risk and easy correctibility.CONCLUSION:Our results demonstrate an overall clear advantage of TRN when compared to simple nephrectomy.

Purpose: A simple non antireflux technique is described for ureteral implantation in to the orthotopic ileal neobladder.

Authors report on their results obtained from orthotopic ileal neobladders following 25 cases of radical cystectomy. Analysis is given of the possible complications, their prevention, as well as of surgical techniques. It is determined that orthotopic ileal neobladder is one of the best bladder substitution methods, giving the patient a chance for a high quality of life.

Authors review their early experiences and the oncopathological relations in respect to 25 cases of radical cystectomy involving orthotopic bladder substitution. The difficulties of diagnostics and indication are discussed. Attention is drawn to the fact that pathological "staging", "grading" are not entirely exact and reliable, though surgical indication is positioned on these. It is the opinion of authors that in case of TIG3 radical surgery is indicated. Due to the shortness of the follow-up periods, no studies on survival were performed. It remains an open question whether radical cystectomy is indicated as opposed to the possible choice of organ-preserving surgery.