PURPOSE: Recalcitrant @entity3832 is a challenging disease. When combined with a defunctionalized bladder, cutaneous urinary diversion is the most common surgical option. We present a novel technique of total lower urinary tract reconstruction, combining salvage cystectomy, ileal neobladder formation and urethral pull-through, as an orthotopic alternative in @entity1 with a defunctionalized bladder and recalcitrant @entity3832 . MATERIALS AND METHODS: We completed a retrospective review of 8 @entity1 who underwent salvage cystectomy, orthotopic ileal neobladder formation and urethral pull-through. Artificial urinary sphincter placement was performed in a staged fashion. Six @entity1 @entity263 treatment including radiation therapy, 1 had urethral disruption after robotic radical prostatectomy, and 1 experienced @entity1494 and urethral distraction injury during a  motorcycle accident. @entity1 demographics, operative variables and postoperative outcomes were examined. RESULTS: No high grade complications were observed after salvage cystectomy, orthotopic neobladder formation and urethral pull-through. After staged artificial urinary sphincter placement, a median of 2 revision surgeries (range 0 to 4) was required to establish social continence. All @entity1 maintained functional urinary storage, urethral patency and social continence at a median followup of 58 months. No @entity1 had complications related to orthotopic neobladder formation, including ureteroileal anastomotic stricture or @entity2885 , and no @entity1 required cutaneous diversion. CONCLUSIONS: Total lower urinary tract reconstruction with cystectomy, ileal neobladder formation and urethral pull-through offers an orthotopic alternative for @entity1 with recalcitrant @entity3832 and defunctionalized bladders. Although it requires staged placement of an artificial urinary sphincter, this approach can offer functional urinary storage, durable urethral patency and avoidance of cutaneous urinary diversion.

Total Bladder and Posterior Urethral Reconstruction: Salvage Technique for Defunctionalized Bladder with Recalcitrant XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'Patient'] @entity263 :: ('MESH:D011471', 'Disease') :: ['received prostate cancer'] @entity1494 :: ('MESH:D001745', 'Disease') :: ['bladder rupture'] @entity3832 :: ('MESH:D014525', 'Disease') :: ['posterior urethral stenosis'] @entity2885 :: ('MESH:D011704', 'Disease') :: ['pyelonephritis']
@entity3832 :: (MESH:D014525,Disease) :: ['Posterior Urethral Stenosis']
