PD43-03 FUNCTIONAL OUTCOMES AFTER RADICAL CYSTECTOMY WITH ILEAL NEOBLADDER

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Ureter (including Pyeloplasty) and Bladder Reconstruction (including fistula), Augmentation, Substitution, Diversion II1 Apr 2018PD43-03 FUNCTIONAL OUTCOMES AFTER RADICAL CYSTECTOMY WITH ILEAL NEOBLADDER Nicolas von Landenberg, Julian Hanske, Sebastian Berg, Jana Schmidt, Marko Brock, Rein-Jüri Palisaar, Christian von Bodman, Florian Roghmann, and Joachim Noldus Nicolas von LandenbergNicolas von Landenberg More articles by this author , Julian HanskeJulian Hanske More articles by this author , Sebastian BergSebastian Berg More articles by this author , Jana SchmidtJana Schmidt More articles by this author , Marko BrockMarko Brock More articles by this author , Rein-Jüri PalisaarRein-Jüri Palisaar More articles by this author , Christian von BodmanChristian von Bodman More articles by this author , Florian RoghmannFlorian Roghmann More articles by this author , and Joachim NoldusJoachim Noldus More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2115AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To assess the functional outcomes after radical cystectomy (RC) with ileal neobladder (INB) in a contemporary cohort of patients with bladder tumor using validated and established questionnaires for continence and sexual function. METHODS The study population consisted of 252 consecutive bladder tumor patients that underwent RC with INB at a single institution between June 2003 and December 2014. The functional follow-up started in January 2011. Continence status was assessed using the daily pad usage >4 months after RC. We defined <=1 pad/24h as continent. Sexual function was evaluated using the International Index of Erectile Function-5 (IIEF-5) and the Female Sexual Function Index-19 (FSFI-19) in women. We defined sexual disorder in men as IIEF<17 and in women as FSFI<26.55. Statistical analyses were conducted (chi2, Kruskal-Wallis, Mann-Whitney U test). RESULTS At the start of functional follow-up, 51 patients were deceased, leading to a final study cohort of 201 patients. Of those, 170/201 (84.6%) were male. Median age at surgery was 61 years (IQR 55–67), 46/201 (22.9%) had a body mass index > 30, 10/201 (5%) had a Charlson Comorbidity Index >=3, 141/201 (70.1%) had an organ defined tumor. Continence questionnaires were returned by 114/201 (56.7%) patients with a continence rate of 79.8% (91/114). IIEF was returned by 88/170 (51.8%) men. Of those, 21/75 (28%) after nerve sparing surgery (NSS) vs. 0/13 (0%) without NSS reported an IIEF>17 (P=0.033). FSFI was returned by 16/31 (51.6%) of the female subgroup. Of those, 3/10 (33%) after NSS vs. 1/6 (16.7%) without NSS reported an FSFI>26.55 (P>0.05). Reported reasons for sexual disorder among those with a FSFI<26.55 were missing partner (4/12; 33.3%), sexual dysfunction of the partner (3/12; 25%), personal age/comorbidities (5/12; 41.7%), incontinence during intercourse (3/12; 25%), dyspareunia (3/12; 25%). There were no significant differences in age, BMI, CCI and tumor stage according to continence status and sexual function. CONCLUSIONS Overall, RC with INB is associated with a relatively low rate of social incontinence. Approximately, one third of the patients that underwent NSS is sexually active after RC. This information should be discussed during patient counseling before RC. Further studies are needed to validate these findings. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e877 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Nicolas von Landenberg More articles by this author Julian Hanske More articles by this author Sebastian Berg More articles by this author Jana Schmidt More articles by this author Marko Brock More articles by this author Rein-Jüri Palisaar More articles by this author Christian von Bodman More articles by this author Florian Roghmann More articles by this author Joachim Noldus More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...