Neobladder Urinary Reconstruction at The Ottawa Hospital: Incidence and Function
CUA Online Library. Vigil H. 06/22/13; 31457; UP-78
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Abstract
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Neobladder Urinary Reconstruction At The Ottawa Hospital: Incidence and Function
Introduction and Objectives: To evaluate the incidence and function of neobladder urinary reconstruction.
Methods: We reviewed a historical cohort of radical cystectomy patients who underwent neobladder urinary reconstruction at our institution between June 2007 and October 2012. Uroflowmetry, post-void residual volumes, daytime continence, nighttime continence, and urinary retention requiring catheterization were routinely assessed 3, 6, and 12 months post-operative.
Results: During the study period 213 patients had a radical cystectomy and 94 (44%) had neobladder urinary reconstruction. Daytime continence was 72% at 3-months and 89% at 6-months and 89% at 12-months. Nighttime continence was 44% at 3- months, 63% at 6-months, and 75% at 12-months. The incidence of urinary retention was 4% at 3 months, 4% at 6-months, and 16% at 12-months. Age and gender were not highly associated with day or nighttime continence (RR~1.0; p>0.05). However, females were more likely to experience urinary retention (RR at 12-months 5.1; p<0.001). Ability to completely empty the neobladder at 3-month post-operative (postvoid residual volume <100cc) was associated with increased 12-month daytime continence (RR 1.5; p=0.08), increased 12-month nighttime continence (RR 2.3; p=0.01) and decreased risk of requiring a urinary catheter (RR 0.6; p=0.09). Uroflowmetry was not highly associated with functional outcomes.
Conclusions: A large proportion of radical cystectomy patients at The Ottawa Hospital receive neobladder reconstruction and most patients experience good urinary function. Further study into neobladder mechanics are warranted to evaluate factors associated with urine storage and emptying.
Introduction and Objectives: To evaluate the incidence and function of neobladder urinary reconstruction.
Methods: We reviewed a historical cohort of radical cystectomy patients who underwent neobladder urinary reconstruction at our institution between June 2007 and October 2012. Uroflowmetry, post-void residual volumes, daytime continence, nighttime continence, and urinary retention requiring catheterization were routinely assessed 3, 6, and 12 months post-operative.
Results: During the study period 213 patients had a radical cystectomy and 94 (44%) had neobladder urinary reconstruction. Daytime continence was 72% at 3-months and 89% at 6-months and 89% at 12-months. Nighttime continence was 44% at 3- months, 63% at 6-months, and 75% at 12-months. The incidence of urinary retention was 4% at 3 months, 4% at 6-months, and 16% at 12-months. Age and gender were not highly associated with day or nighttime continence (RR~1.0; p>0.05). However, females were more likely to experience urinary retention (RR at 12-months 5.1; p<0.001). Ability to completely empty the neobladder at 3-month post-operative (postvoid residual volume <100cc) was associated with increased 12-month daytime continence (RR 1.5; p=0.08), increased 12-month nighttime continence (RR 2.3; p=0.01) and decreased risk of requiring a urinary catheter (RR 0.6; p=0.09). Uroflowmetry was not highly associated with functional outcomes.
Conclusions: A large proportion of radical cystectomy patients at The Ottawa Hospital receive neobladder reconstruction and most patients experience good urinary function. Further study into neobladder mechanics are warranted to evaluate factors associated with urine storage and emptying.
Neobladder Urinary Reconstruction At The Ottawa Hospital: Incidence and Function
Introduction and Objectives: To evaluate the incidence and function of neobladder urinary reconstruction.
Methods: We reviewed a historical cohort of radical cystectomy patients who underwent neobladder urinary reconstruction at our institution between June 2007 and October 2012. Uroflowmetry, post-void residual volumes, daytime continence, nighttime continence, and urinary retention requiring catheterization were routinely assessed 3, 6, and 12 months post-operative.
Results: During the study period 213 patients had a radical cystectomy and 94 (44%) had neobladder urinary reconstruction. Daytime continence was 72% at 3-months and 89% at 6-months and 89% at 12-months. Nighttime continence was 44% at 3- months, 63% at 6-months, and 75% at 12-months. The incidence of urinary retention was 4% at 3 months, 4% at 6-months, and 16% at 12-months. Age and gender were not highly associated with day or nighttime continence (RR~1.0; p>0.05). However, females were more likely to experience urinary retention (RR at 12-months 5.1; p<0.001). Ability to completely empty the neobladder at 3-month post-operative (postvoid residual volume <100cc) was associated with increased 12-month daytime continence (RR 1.5; p=0.08), increased 12-month nighttime continence (RR 2.3; p=0.01) and decreased risk of requiring a urinary catheter (RR 0.6; p=0.09). Uroflowmetry was not highly associated with functional outcomes.
Conclusions: A large proportion of radical cystectomy patients at The Ottawa Hospital receive neobladder reconstruction and most patients experience good urinary function. Further study into neobladder mechanics are warranted to evaluate factors associated with urine storage and emptying.
Introduction and Objectives: To evaluate the incidence and function of neobladder urinary reconstruction.
Methods: We reviewed a historical cohort of radical cystectomy patients who underwent neobladder urinary reconstruction at our institution between June 2007 and October 2012. Uroflowmetry, post-void residual volumes, daytime continence, nighttime continence, and urinary retention requiring catheterization were routinely assessed 3, 6, and 12 months post-operative.
Results: During the study period 213 patients had a radical cystectomy and 94 (44%) had neobladder urinary reconstruction. Daytime continence was 72% at 3-months and 89% at 6-months and 89% at 12-months. Nighttime continence was 44% at 3- months, 63% at 6-months, and 75% at 12-months. The incidence of urinary retention was 4% at 3 months, 4% at 6-months, and 16% at 12-months. Age and gender were not highly associated with day or nighttime continence (RR~1.0; p>0.05). However, females were more likely to experience urinary retention (RR at 12-months 5.1; p<0.001). Ability to completely empty the neobladder at 3-month post-operative (postvoid residual volume <100cc) was associated with increased 12-month daytime continence (RR 1.5; p=0.08), increased 12-month nighttime continence (RR 2.3; p=0.01) and decreased risk of requiring a urinary catheter (RR 0.6; p=0.09). Uroflowmetry was not highly associated with functional outcomes.
Conclusions: A large proportion of radical cystectomy patients at The Ottawa Hospital receive neobladder reconstruction and most patients experience good urinary function. Further study into neobladder mechanics are warranted to evaluate factors associated with urine storage and emptying.
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