PD9-02 HEALTH RELATED QUALITY OF LIFE AFTER RADICAL CYSTECTOMY IN WOMEN: ORTHOTOPIC NEOBLADDER VERSUS ILEAL LOOP CONDUIT AND IMPACT OF INCONTINENCE
| Autor: | Diaa-eddin Taha, Bedeir Ali-El-Dein, Essam M. Zidan, Ahmed M. Harraz, Mohamed Zahran, Mohamed Tharwat, Mona A. El-Bilsha |
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| Rok vydání: | 2015 |
| Předmět: | |
| Zdroj: | Journal of Urology. 193 |
| ISSN: | 1527-3792 0022-5347 |
| DOI: | 10.1016/j.juro.2015.02.929 |
| Popis: | INTRODUCTION AND OBJECTIVES: Orthotopic neobladder reconstruction arguably represents the gold standard form of urinary diversion following radical cystectomy. However, no contemporary continence information is available. Herein, we evaluate the continence outcomes in patients undergoing orthotopic neobladder following radical cystectomy using a validated pad usage questionnaire. METHODS: Using our IRB approved database, we identified 1545 patients that underwent open radical cystectomy from 2000 to 2014. Orthotopic neobladder was constructed in 1057 (68%) patients, of whom 892 (84%) were male. Starting in 2012, these patients were prospectively followed, and completed a validated, pictorial pad usage questionnaire during their follow up visits assessing the number, size, and wetness of pads, and mucus leakage. Continence was defined as reporting no pad usage, or pads as “almost dry,” and questionnaires were stratified into distinct postoperative time intervals. For patients who completed multiple questionnaires within an interval, the most recent was used in the analysis. Patients with artificial urinary sphincters or a history of radiation therapy were excluded. RESULTS: A total of 180 male patients with available pad usage questionnaires were followed from August 2012 to October 2014. A total of 284 pad usage questionnaires were collected, with 243 interval distinct pad usage questionnaires identified and separated into intervals of < 3 months, 3e6 months, 6e12 months, 12e18 months, 18e36 months, and more than 36 months after surgery (n1⁄4 42, 39, 41, 34, 45, and 42, respectively). Daytime continence rates were 55%, 69%, 78%, 88%, 87%, and 81%, respectively. The corresponding numbers for nighttime continence rates were 26%, 38%, 46%, 44%, 58%, and 45%, respectively. In the 18e36 month range, 53% of patients reported both day and nighttime continence. CONCLUSIONS: Following orthotopic urinary diversion, there is significant improvement in continence by 6 months, and 88% of patients achieved daytime continence by 12 months. There is a plateau in continence rates at one year. Orthotopic diversion represents an excellent functional option for urinary diversion. |
| Databáze: | OpenAIRE |
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