We evaluated continence outcomes in male patients undergoing orthotopic neobladder (ONB) diversion following radical cystectomy (RC) using a validated questionnaire.
Using our IRB approved bladder cancer database, we identified 1269 patients who underwent open RC from 2002 to 2015.
ONB was constructed in 935 (74%) patients, of whom 798 (85%) were male. Beginning in 2012, patients completed a validated pictorial pad usage questionnaire at each follow up visit. The questionnaire assesses pad number, size, and wetness, as well as catheter use. Continence was defined as usage of no pads or pads that are "almost dry." Questionnaires were stratified into distinct postoperative time intervals for analysis. Female patients or patients with artificial urinary sphincters or prior radiotherapy were excluded.
A total of 188 male patients with available questionnaires were followed from September 2012 to August 2015. 447 questionnaires were collected, with 351 interval distinct questionnaires separated into intervals of <3 months, 3-6 months, 6-12 months, 12-18 months, 18-36 months, and >36 months after surgery (n= 64, 61, 58, 49, 61, 58 respectively). Daytime continence increased from 59% at <3 months postoperatively to 92% by 12-18 months. Nighttime continence increased from 28% at <3 months postoperatively to 51% by 18-36 months. Nearly fifty percent of patients reported both day and nighttime continence by 18-36 months.
Following ONB diversion in male patients, continence improves significantly by 6 months and subsequently plateaus with 92% daytime continence by 12-18 months. ONB represents an excellent functional option for urinary diversion.
The Journal of urology. 2016 May 30 [Epub ahead of print]
Thomas G Clifford, Swar H Shah, Soroush T Bazargani, Gus Miranda, Jie Cai, Kevin Wayne, Hooman Djaladat, Anne K Schuckman, Siamak Daneshmand
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USC Institute of Urology, USC/Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California., USC Institute of Urology, USC/Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California., USC Institute of Urology, USC/Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California., USC Institute of Urology, USC/Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California., USC Institute of Urology, USC/Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California., USC Institute of Urology, USC/Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California., USC Institute of Urology, USC/Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California., USC Institute of Urology, USC/Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California., USC Institute of Urology, USC/Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California. Electronic address: .