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Clinical experience of the orthotopic W-pouch neobladder for urinary diversion post-radical cystectomy in Indonesia: a multicenter study

E. Mediana¹, S. Hudaya², F. Rahman³, F. Widia³, M. Siregar⁴, G. Binathara⁵, H. Abol-Enein⁶, C. Mochtar³, R. Umbas³, A. Hamid³

¹Bogor Regional General Hospital, Urology, Bogor, Indonesia
²Fatmawati General Hospital, Urology, Jakarta, Indonesia
³Dr. Cipto Mangunkusumo National General Hospital, Urology, Jakarta, Indonesia
⁴Persahabatan General Hospital, Urology, Jakarta, Indonesia
⁵Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
⁶Mansoura University, Urology and Nephrology Center, Mansoura, Egypt

Introduction:

Bladder cancer incidence and mortality vary globally. The standard treatment for muscle-invasive bladder cancer is radical cystectomy (RC) and urinary diversion (UD). Orthotopic neobladder (ONB) improves quality of life over noncontinent diversions. Early clinical experience of ONB reconstruction post-RC in Indonesia is examined in this study.

Material and methods:

This study analyzed clinical data from 32 bladder cancer patients who underwent RC and ONB reconstruction at four Indonesian hospitals between June 2023 and December 2024. Key variables included patient demographics, histopathology type, pathological staging, operative time, blood loss, length of hospital stay, overall complication, and post-operative continence status.

Results:

Of the 32 patients, most were male, with an age range of 33–81 years. The majority had pathological staging of pT1-2N0M0. The mean operative time for RC and ONB was 532.4 minutes, with a mean estimated blood loss of 1,118.8 cc. Hospital stays averaged 12.5 days, with histopathology predominantly revealing transitional cell carcinoma (TCC). The overall complication rate was 37.5%, and the post-operative continence status was 65.6%.