MP13-05 IMPACT OF MICTURITION HABITS ON FUNCTIONAL OUTCOMES OF PATIENTS WITH ORTHOTOPIC NEOBLADDER: RESULTS FROM A SINGLE CENTER PROSPECTIVE RANDOMISED CONTROLLED TRIAL

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive I (MP13)1 Sep 2021MP13-05 IMPACT OF MICTURITION HABITS ON FUNCTIONAL OUTCOMES OF PATIENTS WITH ORTHOTOPIC NEOBLADDER: RESULTS FROM A SINGLE CENTER PROSPECTIVE RANDOMISED CONTROLLED TRIAL Riccardo Mastroianni, Gabriele Tuderti, Umberto Anceschi, Alfredo Maria Bove, Aldo Brassetti, Mariaconsiglia Ferriero, Leonardo Misuraca, Salvatore Guaglianone, Ashanti Zampa, Michele Gallucci, and Giuseppe Simone Riccardo MastroianniRiccardo Mastroianni More articles by this author , Gabriele TudertiGabriele Tuderti More articles by this author , Umberto AnceschiUmberto Anceschi More articles by this author , Alfredo Maria BoveAlfredo Maria Bove More articles by this author , Aldo BrassettiAldo Brassetti More articles by this author , Mariaconsiglia FerrieroMariaconsiglia Ferriero More articles by this author , Leonardo MisuracaLeonardo Misuraca More articles by this author , Salvatore GuaglianoneSalvatore Guaglianone More articles by this author , Ashanti ZampaAshanti Zampa More articles by this author , Michele GallucciMichele Gallucci More articles by this author , and Giuseppe SimoneGiuseppe Simone More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001994.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Functional outcomes of radical cystectomy (RC) with orthotopic ileal neobladder and their predictive variables remain underinvestigated. We aimed to evaluate the impact of voiding time-intervals on both day (d)- and night (n)-time continence in a randomised controlled trial (RCT) cohort of patients comparing open RC (ORC) and robot-assisted RC (RARC) with totally intracorporeal (i) urinary diversion (UD) (NCT03434132). METHODS: Patients were eligible if they had a diagnostic TURBt with cT2-4, cN0, cM0, or recurrent high-grade NMIBC and no anesthesiologic contraindications to robotic surgery. Between Jan 2018 and Sept 2020, 116 patients were enrolled with a covariate adaptive randomization process based on the following variables: BMI, ASA score, preoperative hgb, UD [Padua ileal bladder (PIB) or ileal conduit], neoadjuvant chemotherapy and cT-stage. Logistic regression (LR) was performed to build a model to predict d- and n-time continence using a voiding cut-off time. RESULTS: Out of 116 patients enrolled, 88 received PIB and 71 were included in the study (12 patients died, 1 was lost to follow-up, 1 was hypercontinent, 1 had a stroke and 2 had permanent catheter). Baseline clinical data were reported in Table 1. RARC with iPIB was performed with no need of open conversion. At a median follow-up of 16 months (IQR: 11-28), 60 patients (85%) were d-time continent, and 45 (63%) were n-time continent. Patients who had d-time voiding intervals <3h had higher probability to be d-time continent (88%vs64%;p=0.04); similarly, n-time continence probabilities were higher when n-time voiding intervals were <3h (76%vs47%;p=0.01). At LR analysis, for each hour increase in voiding intervals, d-time and n-time continence probabilities decreased of 41% (HR: 0.587; 95%CI 0.424-0.813;p=0.001). In d-time continent patients, LR demonstrated that for each hour increase n-time continence probability decreased of 49% (HR: 0.514; 95%CI 0.353-0.749; p=0.001). CONCLUSIONS: This study supports the key role of micturition habits on functional outcomes of neobladder patients. Patients should be preoperatively counseled about the need to respect voiding cut-off time of 3h to achieve optimal functional results. Source of Funding: none © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e244-e244 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Riccardo Mastroianni More articles by this author Gabriele Tuderti More articles by this author Umberto Anceschi More articles by this author Alfredo Maria Bove More articles by this author Aldo Brassetti More articles by this author Mariaconsiglia Ferriero More articles by this author Leonardo Misuraca More articles by this author Salvatore Guaglianone More articles by this author Ashanti Zampa More articles by this author Michele Gallucci More articles by this author Giuseppe Simone More articles by this author Expand All Advertisement Loading ...