Prospective Evaluation of Continence Following Radical Cystectomy and Orthotopic Urinary Diversion Using a Validated Questionnaire

No AccessJournal of UrologyAdult Urology1 Dec 2016Prospective Evaluation of Continence Following Radical Cystectomy and Orthotopic Urinary Diversion Using a Validated Questionnaire Thomas G. Clifford, Swar H. Shah, Soroush T. Bazargani, Gus Miranda, Jie Cai, Kevin Wayne, Hooman Djaladat, Anne K. Schuckman, and Siamak Daneshmand Thomas G. CliffordThomas G. Clifford More articles by this author , Swar H. ShahSwar H. Shah More articles by this author , Soroush T. BazarganiSoroush T. Bazargani More articles by this author , Gus MirandaGus Miranda More articles by this author , Jie CaiJie Cai More articles by this author , Kevin WayneKevin Wayne More articles by this author , Hooman DjaladatHooman Djaladat More articles by this author , Anne K. SchuckmanAnne K. Schuckman More articles by this author , and Siamak DaneshmandSiamak Daneshmand More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.05.093AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluated continence outcomes in male patients undergoing orthotopic neobladder diversion after radical cystectomy using a validated questionnaire. Materials and Methods: Using our institutional review board approved bladder cancer database we identified 1,269 patients who underwent open radical cystectomy from 2002 to 2015. Orthotopic neobladder was constructed in 935 (74%) patients, of whom 798 (85%) were male. Beginning in 2012 the patients completed a validated pictorial pad use questionnaire at each followup visit. The questionnaire assessed pad number, size and wetness as well as catheter use. Continence was defined as use of no pads or pads that are almost dry. Questionnaires were stratified into distinct postoperative intervals for analysis. Female patients, or patients with artificial urinary sphincters or prior radiotherapy were excluded from the study. Results: A total of 188 male patients with available questionnaires were followed from September 2012 to August 2015. Overall 447 questionnaires were collected, with 351 interval distinct questionnaires separated into intervals of less than 3, 3 to 6, more than 6 to 12, more than 12 to 18, more than 18 to 36 and more than 36 months after surgery (64, 61, 58, 49, 61 and 58 questionnaires, respectively). Daytime continence increased from 59% at less than 3 months postoperatively to 92% by more than 12 to 18 months. Nighttime continence increased from 28% at less than 3 months postoperatively to 51% by more than 18 to 36 months. Nearly 50% of patients reported daytime and nighttime continence by 18 to 36 months. Conclusions: After orthotopic neobladder diversion in male patients, continence improves significantly by 6 months and subsequently plateaus with 92% daytime continence by more than 12 to 18 months. Orthotopic neobladder represents an excellent functional option for urinary diversion. References 1 : Choosing the right urinary diversion: patient’s choice or surgeon’s inclination?. Urol Oncol2011; 29: 473. Google Scholar 2 : Factors influencing the choice of urinary diversion in patients undergoing radical cystectomy. BJU Int2010; 106: 654. Google Scholar 3 : Urinary diversion 2015: controversies and new technologies: choosing the ‘right’ diversion. Curr Opin Urol2015; 25: 543. Google Scholar 4 : Improving selection of appropriate urinary diversion following radical cystectomy for bladder cancer. Expert Rev Anticancer Ther2011; 11: 941. Google Scholar 5 : Twenty years experience with an ileal orthotopic low pressure bladder substitute–lessons to be learned. J Urol2006; 176: 161. 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Link, Google Scholar © 2016 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byHautmann R, Volkmer B, Egghart G, Frohneberg D, Gottfried H, Gschwend J, Hefty R, Kleinschmidt K, Küfer R, Miller K, de Petriconi R, Simon J and Wenderoth U (2020) Functional Outcome and Complications following Ileal Neobladder Reconstruction in Male Patients without Tumor Recurrence. More than 35 Years of Experience from a Single CenterJournal of Urology, VOL. 205, NO. 1, (174-182), Online publication date: 1-Jan-2021.Palmer C, Farhan B, Nguyen N, Zhang L, Do R, Nguyen D and Ghoniem G (2018) Are Electronic and Paper Questionnaires Equivalent to Assess Patients with Overactive Bladder?Journal of Urology, VOL. 200, NO. 2, (369-374), Online publication date: 1-Aug-2018.Smith J (2016) This Month in Adult UrologyJournal of Urology, VOL. 196, NO. 6, (1599-1600), Online publication date: 1-Dec-2016. Volume 196Issue 6December 2016Page: 1685-1691 Advertisement Copyright & Permissions© 2016 by American Urological Association Education and Research, Inc.Keywordscystectomyurinary incontinenceurinary diversionMetricsAuthor Information Thomas G. Clifford More articles by this author Swar H. Shah More articles by this author Soroush T. Bazargani More articles by this author Gus Miranda More articles by this author Jie Cai More articles by this author Kevin Wayne More articles by this author Hooman Djaladat More articles by this author Anne K. Schuckman More articles by this author Siamak Daneshmand More articles by this author Expand All Advertisement PDF downloadLoading ...