INTRODUCTION: An orthotopic neobladder urinary diversion aims to minimize the physical and psychological effects of radical cystectomy through avoidance of a stoma and maintenance of urethral voiding. Neobladder function reported in the literature ranges widely due to differences in patient selection and method of assessment. The objective of the study was to characterize functional outcomes of consecutive patients treated at a tertiary care hospital. METHODS: A historical cohort of patients who underwent radical cystectomy with a neobladder diversion performed at The Ottawa Hospital between January 2006 and December 2014 were reviewed. Outcomes of interest were urinary continence, use of clean intermittent catheterization (CIC), post-void residual volume, and uroflowmetry at three, six, and 12 months following cystectomy. RESULTS: During the study period, 158 neobladder diversions were performed. The mean age of patients was 63.1 years (standard deviation [SD] 8.1), and 81.7% were male. Significant daytime incontinence (>1 pad) three months following surgery was common (65%), but decreased to 8.6% by 12 months. Nighttime incontinence was also common at three months (54%) and improved at 12 months (20%). While no appreciable differences between men and women were observed for continence, more women performed CIC at 12 months post-surgery (59% of women; 9% of men; relative risk [RR] 0.15; 95% confidence interval [CI] 0.07-0.30). Among patients who did not catheterize, uroflowmetry and post-void residual volume parameters were stable between three and 12 months postoperative. CONCLUSIONS: Daytime and nighttime incontinence is common in neobladder patients following surgery, but improves considerably with time. Correspondingly, many female neobladder patients at our institution use CIC.
INTRODUCTION: An orthotopic neobladder urinary diversion aims to minimize the physical and psychological effects of radical cystectomy through avoidance of a stoma and maintenance of urethral voiding. Neobladder function reported in the literature ranges widely due to differences in patient selection and method of assessment. The objective of the study was to characterize functional outcomes of consecutive patients treated at a tertiary care hospital. METHODS: A historical cohort of patients who underwent radical cystectomy with a neobladder diversion performed at The Ottawa Hospital between January 2006 and December 2014 were reviewed. Outcomes of interest were urinary continence, use of clean intermittent catheterization (CIC), post-void residual volume, and uroflowmetry at three, six, and 12 months following cystectomy. RESULTS: During the study period, 158 neobladder diversions were performed. The mean age of patients was 63.1 years (standard deviation [SD] 8.1), and 81.7% were male. Significant daytime incontinence (>1 pad) three months following surgery was common (65%), but decreased to 8.6% by 12 months. Nighttime incontinence was also common at three months (54%) and improved at 12 months (20%). While no appreciable differences between men and women were observed for continence, more women performed CIC at 12 months post-surgery (59% of women; 9% of men; relative risk [RR] 0.15; 95% confidence interval [CI] 0.07-0.30). Among patients who did not catheterize, uroflowmetry and post-void residual volume parameters were stable between three and 12 months postoperative. CONCLUSIONS: Daytime and nighttime incontinence is common in neobladder patients following surgery, but improves considerably with time. Correspondingly, many female neobladder patients at our institution use CIC.
Authors: Richard K Lee; Hassan Abol-Enein; Walter Artibani; Bernard Bochner; Guido Dalbagni; Siamak Daneshmand; Yves Fradet; Richard E Hautmann; Cheryl T Lee; Seth P Lerner; Armin Pycha; Karl-Dietrich Sievert; Arnulf Stenzl; Georg Thalmann; Shahrokh F Shariat Journal: BJU Int Date: 2014-01 Impact factor: 5.588
Authors: M A Cerruto; C D'Elia; S Siracusano; X Gedeshi; A Mariotto; M Iafrate; M Niero; C Lonardi; P Bassi; E Belgrano; C Imbimbo; M Racioppi; R Talamini; S Ciciliato; L Toffoli; M Rizzo; F Visalli; P Verze; W Artibani Journal: Eur J Surg Oncol Date: 2015-11-09 Impact factor: 4.424
Authors: Richard E Hautmann; Hassan Abol-Enein; Thomas Davidsson; Sigurdur Gudjonsson; Stefan H Hautmann; Henriette V Holm; Cheryl T Lee; Frederik Liedberg; Stephan Madersbacher; Murugesan Manoharan; Wiking Mansson; Robert D Mills; David F Penson; Eila C Skinner; Raimund Stein; Urs E Studer; Joachim W Thueroff; William H Turner; Bjoern G Volkmer; Abai Xu Journal: Eur Urol Date: 2012-08-31 Impact factor: 20.096
Authors: Jong Hyun Tae; Jong Hyun Pyun; Ji Sung Shim; Seok Cho; Sung Gu Kang; Young Hwii Ko; Jun Cheon; Jeong Gu Lee; Seok Ho Kang Journal: Investig Clin Urol Date: 2019-10-07