To investigate the effectiveness and feasibility of neobladder-urethra drag-and-bond anastomosis in the laparoscopic radical cystectomy and orthotopic ileal neobladder.

Neobladder-urethra anastomosis on 22 patients with invasive bladder cancer who underwent laparoscopic radical cystectomy and orthotopic ileal neobladder formation from January 2016 to July 2019 in the Second Affiliated Hospital of Nanchang Univrsity were performed.

All patients underwent the novel anastomosis for neobladder and urethra. It took 10-18 minutes with an average of 15 minutes for the neobladder-urethra anastomosis. The JP(Jackson-Pratt) drain was removed in all patients on the fourth day except one patient whose drain was removed on the seventh day due to urine leak. Foleys catheter was removed in all patients in 2 weeks postoperation. All patients voided spontaneously without dysuria. Nine patients (9/20) developed urinary incontinence. Of these nine patients, three patients recovered in two week, four patients recovered in four weeks, and two patients recovered in eight weeks. Double J stents were removed via cystoscopy after eight weeks. In cystoscopy, the area of the neobladder-urethra anastomosis appeared patent and flat in all cases without obstruction. After 12 weeks of surgery, the residual bladder volume of the neobladder was less than 15 ml by B-ultrasound and the maximum urine flow rate was 19.3 ml/s on average, the anastomotic site appeared open and flat on retrograde urethrogram without leak-urine with 3-14 month-follow-up.

The neobladder-urethra drag-and-bond anastomosis in laparoscopic radical cystectomy and the neobladder-urethra anastomosis was safe, effective, simple and feasible, with a short learning curve and good outcomes.