PURPOSE: Orthotopic neobladder (ONB) reconstruction is the preferred method of urinary diversion following radical cystoprostatectomy (RC).
We evaluated urinary functional outcomes in male patients following ONB using a patient questionnaire.
MATERIALS AND METHODS: Between 2002 and 2009, patients with bladder cancer were enrolled in a clinical trial randomly assigned to undergo T pouch or Studer pouch diversion following RC. Male patients who were ≥ 12 months out from surgery were mailed a questionnaire including items on urinary function, intermittent catheterization (CIC), number/size/wetness of pads, and mucous leakage.
RESULTS: The response rate was 68%. Mean follow-up period was 4.5 years (range, 1-8). Only 22.3 % of patients did not use pads. In the daytime, 47% used at least 1 pad, 32.2% used small/mini and 22.6% diapers. At night, 72% used pads, 14.7% used small/mini and 38.9% diapers. In both day and night, 47% said their pads were dry/barely wet. 62.5% of patients reported mucus leakage. Only 9.5% performed CIC of whom, 70.6% started CIC within first year after surgery. Increasing age and diabetes mellitus (DM) were predictors of urinary function (P=0.005 and 0.03, respectively) but did not affect pad usage.
CONCLUSION: Ileal ONB offers good functional results but most patients wear at least one pad and many patients require diapers at night. Increasing age and DM predict worse urinary function but are not associated with pad usage. Emptying failure is uncommon and occurs early in postoperative period. Pad size/wetness and mucus leakage should be considered when evaluating UI.
Written by:
Ahmadi H, Skinner EC, Simma-Chiang V, Miranda G, Cai J, Penson DF, Daneshmand S. Are you the author?
Institute of Urology, USC/Norris Comprehensive Cancer Center, Los Angeles, CA, USA.
Reference: J Urol. 2012 Nov 15. pii: S0022-5347(12)05572-3.
doi: 10.1016/j.juro.2012.11.078
PubMed Abstract
PMID: 23159582
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