Maxime Pattou1, Michael Baboudjian2, Ugo Pinar1, Jérôme Parra1, Morgan Rouprêt1,3, Gilles Karsenty2, Véronique Phe4,5. 1. Department of Urology, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Academic Hôpital, Sorbonne University, Paris, France. 2. Department of Urology and Kidney Transplantation, Assistance Publique-Hôpitaux de Marseille, La Conception Hospital, Aix Marseille University, Marseille, France. 3. GRC5 Predictive Onco-urology, Sorbonne University, Paris, France. 4. GRC5 Predictive Onco-urology, Sorbonne University, Paris, France. veronique.phe@aphp.fr. 5. Department of Urology, Assistance-Publique-Hôpitaux de Paris, Tenon Academic Hôpital, Sorbonne University, 4 rue de la Chine, 75020, Paris, France. veronique.phe@aphp.fr.
Abstract
PURPOSE: Radical cystectomy (RC) is currently the standard of care for non-metastatic muscle invasive bladder cancer. Few studies compare methods of cutaneous continent urinary diversion (CCUD) following RC. The objective was to compare perioperative morbidity and functional outcomes of CCUD using an ileal pouch with a Mitrofanoff efferent versus a Miami ileocolic pouch in patients undergoing cystectomy of pelvic exenteration for bladder cancer. METHODS: This retrospective two-centre study included all consecutive patients who underwent radical cystectomy or pelvic exenteration with CCUD for bladder cancer between 2001 and 2020 in two academic French hospitals with a median follow-up time of 5.4 years. Patients were divided into two groups according to the type of urinary diversion: Miami ileocolonic pouch (group A) and ileal pouch with Mitrofanoff/Monti principle (group B). Continence rate, ability to perform intermittent self-catheterisation, complications and health-related quality of life (HRQoL) measured by the bladder cancer index were evaluated. RESULTS: Thirty-one patients were included. Continence was achieved in 11 out of 14 patients (79%) in group A versus 12 out of 17 patients (71%) in group B (P = 0.3). A significantly higher rate of cutaneous tube stenosis was reported in group B compared to group A (eight (47%) vs. one (7%) patient, respectively; P = 0.02). HRQoL outcomes were similar in both groups except less digestive discomfort observed in group A. CONCLUSIONS: When comparing the ileal pouch with Mitrofanoff/Monti's principle with a Miami pouch, no significant differences were found regarding continence rate, ability to self-catheterise, long-term complication rate and overall patient satisfaction.
PURPOSE: Radical cystectomy (RC) is currently the standard of care for non-metastatic muscle invasive bladder cancer. Few studies compare methods of cutaneous continent urinary diversion (CCUD) following RC. The objective was to compare perioperative morbidity and functional outcomes of CCUD using an ileal pouch with a Mitrofanoff efferent versus a Miami ileocolic pouch in patients undergoing cystectomy of pelvic exenteration for bladder cancer. METHODS: This retrospective two-centre study included all consecutive patients who underwent radical cystectomy or pelvic exenteration with CCUD for bladder cancer between 2001 and 2020 in two academic French hospitals with a median follow-up time of 5.4 years. Patients were divided into two groups according to the type of urinary diversion: Miami ileocolonic pouch (group A) and ileal pouch with Mitrofanoff/Monti principle (group B). Continence rate, ability to perform intermittent self-catheterisation, complications and health-related quality of life (HRQoL) measured by the bladder cancer index were evaluated. RESULTS: Thirty-one patients were included. Continence was achieved in 11 out of 14 patients (79%) in group A versus 12 out of 17 patients (71%) in group B (P = 0.3). A significantly higher rate of cutaneous tube stenosis was reported in group B compared to group A (eight (47%) vs. one (7%) patient, respectively; P = 0.02). HRQoL outcomes were similar in both groups except less digestive discomfort observed in group A. CONCLUSIONS: When comparing the ileal pouch with Mitrofanoff/Monti's principle with a Miami pouch, no significant differences were found regarding continence rate, ability to self-catheterise, long-term complication rate and overall patient satisfaction.
Authors: Simon P Kim; Nilay D Shah; Christopher J Weight; R Houston Thompson; Jeffrey K Wang; R Jeffrey Karnes; Leona C Han; Jeanette Y Ziegenfuss; Igor Frank; Matthew K Tollefson; Stephen A Boorjian Journal: BJU Int Date: 2013-03-01 Impact factor: 5.588
Authors: Emery M Salom; Luis E Mendez; Dana Schey; Nicholas Lambrou; Noor Kassira; Orlando Gómez-Marn; Hervy Averette; Manuel Peñalver Journal: Am J Obstet Gynecol Date: 2004-04 Impact factor: 8.661