الفهرس 
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Abstract
Orthotopic bladder substitution after radical cystectomy has gained wide acceptance in the last decades. Different bowel segments with different configurations have heen utilized to construct the intestinal neobladder. However, it is universally accepted that detubularization provides the best urodynamic features of the reservoir.
In this work, we used 3 different detubularized ileal pouches, Y shaped, Camey II and W shaped ileal neobladder and we studied the impact of changing pouch configuration on the continence status, pouchometric characteristics of the used substitutes and the functional integrity of the upper tract.
In this study, 45 patients underwent radical cysto- prostatectomy and
detubularized ileal bladder substitution, the patients were classified as 15 patients in group I (Y shaped ileal neobladder), 15 patients in group II (Camey II ileal neobladder) and 15 patients in group III (W shaped ileal neobladder).
Regarding uretero-intestinal anastomosis, it was direct anastomosis
in group 1, Le- Duc ureteral implantation in group II and extra mural serous lined tunneled ureteral implantation in group III.
Continence was evaluated both diurnally and nocturnally in the early and late post operative period, also, urodynamic studies using uroflowmetry, filling cystometry and urethral pressure profilometry were done for all patients about six months postoperatively.
Renal configuration was monitored by abdominal ultrasonography, intra-venous urography and ascending and micturating pouchogram.
Renal function was evaluated by estimation of blood urea and serum creatinine levels. Metabolic assessment of serum electrolytes (Na +, K+, CL -, and urine culture were performed.
Total diurnal continence was achieved by 80% of the Y shaped ileal bladders, in 66.6% of group II (Camey II ileal neobladder) and in 66.6% in group III (W-shaped ileal neobladders).
Continence with stress urinary incontinence was found in 20% of group I (Y shaped ileal bladders) &13.3% in group II (Camey II ileal bladders) and 20% of group III (W shaped ileal bladders).
Regarding nocturnal continence, complete nocturnal continence was achieved in 66.6% of group I (Y shaped ileal bladders), 60% of group II (Camey II ileal neobladder) and 60% of group III (W-shaped ileal neobladders).