After bladder cancer undergoes radical surgery, in situ neobladder is used, which is a new bladder made from small intestine or large intestine and connected with urethra. After selecting patients suitable for this surgery, most patients can control urine and urinate by themselves through urethra after surgery, and patients’ quality of life is improved.
However, possible complications after surgery include poor urine control and even urinary incontinence, unclean urination, accumulation of large amounts of urine in the new bladder, and the need for catheterization; some patients have metabolic disorders, metabolic acidosis, and new bladder stones in the body due to incomplete urination. A few others may develop extended hydronephrosis of the kidney and ureter, which affects renal function. Therefore, regular lifelong follow-up is required after surgery.
We recently successfully managed a patient with metabolic acidosis, renal insufficiency, electrolyte disturbances, and giant new bladder stones after in situ neobladder surgery, again demonstrating the importance of regular patient follow-up.
The patient underwent radical bladder cancer surgery with in situ neobladder in 2001. After two postoperative reviews, the patient thought that he recovered well and did not return to the hospital. This time, he went to the local hospital because of lower abdominal discomfort and difficulty in urination. As a result, once the examination revealed acidosis, low potassium, low calcium, and huge stones in the new bladder, he was recommended to come to our hospital. After several consultations and treatment adjustments to correct the low potassium, low calcium and acidosis, he had a new cystotomy to remove the stone, bilateral ureteral release, bilateral ureteral new bladder reimplantation and intestinal adhesion release.