Voiding and renal function 10 years after radical cystectomy and orthotopic neobladder in women.

Autor: Zahran MH; Faculty of Medicine, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt., Harraz AM; Faculty of Medicine, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt., Baset MA; Faculty of Medicine, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt., El-Baz R; Faculty of Medicine, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt., Shaaban AA; Faculty of Medicine, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt., Ali-El-Dein B; Faculty of Medicine, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
Jazyk: angličtina
Zdroj: BJU international [BJU Int] 2023 Sep; Vol. 132 (3), pp. 291-297. Date of Electronic Publication: 2023 Apr 10.
DOI: 10.1111/bju.16011
Abstrakt: Objectives: To assess long-term voiding and renal function (RF) changes after radical cystectomy (RC) and orthotopic neobladder (ONB) surgery in women without disease recurrence.
Material and Methods: Women who underwent RC and ONB reconstruction between 1995 and 2011 were included in this study. Patients who developed disease failure or were lost to follow-up were excluded. The study outcomes were long-term voiding function and the incidence and predictors of RF deterioration (defined as >20% decline of baseline). Analysis was performed using the log-rank test and Cox regression analysis.
Results: The study included 195 patients with a median (interquartile range) follow-up of 98 (53-151) months, of whom 95 had >10 years of follow-up. Daytime continence, night-time continence and chronic urine retention (CUR) were identified in 170 (87%), 134 (69%) and 52 patients (27%), respectively. Among patients with >10 years of follow-up, 82 (86%), 66 (70%) and 31 (33%) had daytime continence, night-time continence and CUR at the last follow-up visit, respectively. RF deterioration events occurred in 74 patients throughout the follow-up and chronic kidney disease (CKD) stage III-V developed in 80 patients. Patients' age (hazard ratio [HR] 1.41, 95% confidence interval [CI]1.06-1.89; P = 0.02) and serous-lined extramural tunnel diversion (HR 0.43, 95% CI 0.19-0.86; P = 0.02) were the independent predictors of RF deterioration. Among patients with >10 years of follow-up, RF deteriorated in 46 patients (49%) and CKD stage III-V developed in 40 (42%).
Conclusion: Women surviving more than 10 years after RC and ONB maintained acceptable continence status, apart from having a higher CUR rate, compared to those followed for <10 years. However, RF deterioration developed in nearly half of them.
(© 2023 BJU International.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje