PD43-02 EVALUATION OF URINARY CONTINENCE FOLLOWING NERVE SPARING OPEN RADICAL CYSTOPROSTATECTOMY AND ORTHOTOPIC URINARY DIVERSION

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Ureter (including Pyeloplasty) and Bladder Reconstruction (including fistula), Augmentation, Substitution, Diversion II1 Apr 2018PD43-02 EVALUATION OF URINARY CONTINENCE FOLLOWING NERVE SPARING OPEN RADICAL CYSTOPROSTATECTOMY AND ORTHOTOPIC URINARY DIVERSION Zhoobin Bateni, Ankeet Shah, Soroush Bazargani, Kevin Wayne, Gus Miranda, Jie Cai, Hooman Djaladat, Anne Schuckman, and Siamak Daneshmand Zhoobin BateniZhoobin Bateni More articles by this author , Ankeet ShahAnkeet Shah More articles by this author , Soroush BazarganiSoroush Bazargani More articles by this author , Kevin WayneKevin Wayne More articles by this author , Gus MirandaGus Miranda More articles by this author , Jie CaiJie Cai More articles by this author , Hooman DjaladatHooman Djaladat More articles by this author , Anne SchuckmanAnne Schuckman More articles by this author , and Siamak DaneshmandSiamak Daneshmand More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2114AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES It has been suggested that nerve-sparing (NS) techniques can improve urinary continence following radical prostatectomy but there is lack of strong evidence in the literature about the effect of NS techniques on urinary continence following radical cystoprostatectomy (RCP). We evaluated urinary continence in male patients undergoing ONB diversion following NS versus non-NS RCP using a validated pad usage questionnaires. METHODS Beginning in 2012, we started to use an IRB approved, validated, pictorial pad usage questionnaire assessing the number, size, and wetness of pads at each follow-up visits of patients with ONB. We found 253 male patients which had filled out pad usage questionnaires at least one time. The time of the RCP was from 2002 to 2017. Continence was defined as no pad usage or pads as almost dry. We evaluated whether a nerve-sparing approach had any impact on continence. RESULTS The median age of 67 years and median BMI of 27.3 kg/m2. The median follow-up was 729 days. There was no significant difference between pathologic stage, adjuvant or neoadjuvant therapies, BMI, diabetes, history of smoking and perioperative care/catheter management of the two groups. There was a significantly shorter median time to daytime continence in the NS group compared to non-NS group (133 days vs 216 days; p=0.01). Kaplan-Meier curves showed significantly higher daytime continence rates in NS group at one year compared to non-NS ones (63% +/- 5% vs. 54% +/- 4%; p=0.002). A similar pattern was observed for one-year nighttime continence rates between the groups (43% +/- 5% in NS vs. 35% +/- 4% in non-NS; p=0.011) (figure 1). After controlling for potentially confounding factors including age, BMI, diabetes, comorbidities, smoking, pathological stage, pelvic floor muscle training, operative time, and blood loss, multivariate Cox regression model revealed that patients in NS group, were 1.6 times more likely to gain daytime continence by one year (OR:1.6 [95%CI, 1.2-2.2]; p=0.003). CONCLUSIONS Men with ONB following NS RCP have faster return to daytime and nighttime continence in the first year compared to the non-NS ones. Further research with randomization and a larger sample size is needed to rule out confounding factors to support the value of doing NS surgery on continence after RCP and ONB. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e877 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Zhoobin Bateni More articles by this author Ankeet Shah More articles by this author Soroush Bazargani More articles by this author Kevin Wayne More articles by this author Gus Miranda More articles by this author Jie Cai More articles by this author Hooman Djaladat More articles by this author Anne Schuckman More articles by this author Siamak Daneshmand More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...