THESE_EL MAJDOUB.pdf - Toubkal

SUMMARYINTRODUCTION: radical cystectomy is the gold standard regarding thetreatment of infiltrating bladder cancer. Bladder replacement is the type ofderivation the most comfortable for patients because it respects the body schema.The mail of our work is to study the epidemiological characteristics; the functionaland oncological results in our context.MATERIEL AND METHOD: from 2003 to 2009; 8 bladder replacements havebeen performed in the department of urlogy at CHU HASSAN II FES, allowing anevaluation of the epidemiological characteristics (age, antecedents…); clinical,functional and oncological data, also short and long term complications.RESULTS: the average age of our patients was 57 years, one patient washypertensive. The day continence is conserved in > 60 %; nocturnal in > 50 %, 2patients had benefited a replacement according to CAMEY, 4 according HAUTMANand 2 according to GHONEIM. One patient presented infection of the abdominal wall.DISCUSSION: the replacement surgery of the bladder has experienced rapiddevelopment over the last twenty years. The use of the digestive tube remains thereference to the bladder replacement. The integration of the segments isolated fromdigestive into the urinary tracts involves risks early and late as metabolic disorders,malabsorption syndromes or a possible formation of cancer.CONCLUSION: choosing the method of bladder replacement should be adaptedto each patient, to this age, to his medical condition, to his psychological state andsocial situation.157