The Study Development Of Female Neobladder Continence Mechanism

Total cystectomy has been used in clinical treatment of bladder cancer for hundreds of years. There are many ways for urinary diversion after total cystectomy with simple operation and fewer complications, and they have obviously improved the postoperative life quality of patients. Furthermore, the urinary diversion close to physiology is the effort and aim of vast number of clinical workers of urology. Since 1987 female orthotopic urinary diversion has been carried out. With the in-depth study of female partial bladder urethral anatomy, in the past twenty years, female orthotopic urinary diversion has been extensively applied in the whole world. It has a new recognition of functions of bladder neck, urethra, rhabdosphincter, urethra-support structures and innervations of these structures in the functions of female continence, informed and improved the application of female orthotopic neobladder surgery, and enhanced clinical results and patient life quality. However, in clinical practice, there would still be of many complications such as urinary retention, incontinence and tumor recurrence of urethra. In the aspects of the urethra retention of female bladder cancer, whether orthotopic neobladder can reach satisfied continence effect, there are still some disputes.Women's continence involves many factors like local anatomy, nerve, physiology, endocrine, and defects in any of the factors would result in urinary control disorders, leading to urinary incontinence or over continence. While in the study of female continence mechanism, it is discovered that under the circumstances of completely retention of urethra rhabdosphincter structure and functions, and using other proper continence technologies, orthotopic urinary diversion for women patients could get better continence results.With the further study of female continence mechanism, the method of female neobladder operation would be further improved. It has reason to believe that the female neobladder operation can obtain the same good postoperative continence function as male and significantly reduce the incidence of postoperative complications. At that time, the female neobladder operation will be the first choice of urinary reconstruction after cystectomy for women.