A 60-year-old man undergoes radical cystectomy for muscle-invasive bladder cancer (MIBC). The pathology shows pT3b N1 M0 urothelial carcinoma. The urinary diversion created involves an ileal segment anastomosed to the urethra allowing voluntary voiding. This diversion is called:
- A Ileal conduit (Bricker diversion)
- B Orthotopic neobladder (Studer or Hautmann pouch) ✓
- C Indiana pouch (continent cutaneous diversion)
- D Ureterosigmoidostomy
Correct answer: B. Orthotopic neobladder (Studer or Hautmann pouch)
Explanation
An orthotopic neobladder (Studer or Hautmann technique) uses a detubularised ileal segment anastomosed to the native urethra, allowing voluntary voiding through Valsalva/abdominal straining. It is the only urinary diversion permitting voiding per urethra. Ileal conduit drains via a cutaneous stoma (urinary bag required). Indiana pouch is continent cutaneous (catheterised via stoma). Ureterosigmoidostomy channels urine into the sigmoid colon (associated with hyperchloraemic acidosis).
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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