You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Ureter (including Pyeloplasty) and Bladder Reconstruction (including fistula), Augmentation, Substitution, Diversion II1 Apr 2017PD38-04 OBJECTIVELY DEFINED URINARY CONTINENCE AFTER RADICAL CYSTECTOMY AND ILEAL ORTHOTOPIC NEOBLADDER: EFFECTS ON HEALTH-RELATED QUALITY OF LIFE Alexander Kretschmer, Tobias Grimm, Alexander Buchner, Markus Grabbert, Maria Apfelbeck, Birte-Swantje Schneevoigt, Friedrich Jokisch, Gerald Schulz, Ricarda M. Bauer, Christian G. Stief, and Alexander Karl Alexander KretschmerAlexander Kretschmer More articles by this author , Tobias GrimmTobias Grimm More articles by this author , Alexander BuchnerAlexander Buchner More articles by this author , Markus GrabbertMarkus Grabbert More articles by this author , Maria ApfelbeckMaria Apfelbeck More articles by this author , Birte-Swantje SchneevoigtBirte-Swantje Schneevoigt More articles by this author , Friedrich JokischFriedrich Jokisch More articles by this author , Gerald SchulzGerald Schulz More articles by this author , Ricarda M. BauerRicarda M. Bauer More articles by this author , Christian G. StiefChristian G. Stief More articles by this author , and Alexander KarlAlexander Karl More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1718AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Comparability of current literature regarding the impact of stress urinary incontinence (SUI) outcomes after radical cystectomy (RC) and orthotopic ileal neoblader (ONB) on health-related quality of life (HRQOL) is impaired since definitions of continence vary and are usually based on subjective patient reports on pad usage. In addition, previous studies analysed women only, focused on particular subdivisions of HRQOL, or did not analyse the impact of assistive devices such as condom catheters and clean intermittent self-catheterization. In the current study, we correlate objectified and detailed continence outcomes with HRQOL after ONB. METHODS Questionnaires were sent to 244 patients who underwent RC with ONB diversion between 2004 and 2015, and information about the current continence status was retrieved. To objectify postoperative urine loss, daytime and nocturnal pad tests were performed. Continence was also assessed using the validated ICIQ-SF score. Continence was defined as need of up to one safety pad and urine loss of <10g per pad test. HRQOL was assessed using the validated EORTC QLQ-C30 score. Statistical analysis included Fisher test, Mann-Whitney-U test, Spearman rank correlation, and binary regression models (p<0.05). RESULTS 178 patients (73.0%) answered the QLQ-C30 questionnaires and were included in the study. Median follow-up was 61 months. Median daytime pad use was 1 and median daily urine loss based on pad testing was 4.0g, leading to a daytime continence rate of 48.5%. The mean daily urine loss based on 24hrs pad testing correlated significantly with decreased physical functioning (R=-0.355, p<0.001), and global health status (R=-0.282, p<0.001). Continence success had a significant impact on postoperative global health status (p=0.017). In addition, we found a significantly decreased global health status for patients using a condom catheter (p=0.049) and patients suffering from pollacisuria (p=0.001). Patients who had performed pelvic floor muscle training had a significantly better global health status (p=0.035). In multivariate analysis, only ICIQ-SF score (p=0.001, OR=0.805) and need for condom catheters (p=0.015, OR=0.123) were independent predictors for worse HRQOL outcomes based on global health status. A history of pelvic floor muscle training was an independent predictor of increased HRQOL (p=0.009, OR=10.459). CONCLUSIONS This is the first study to correlate objective continence outcomes with HRQOL after RC and ONB. Need of condom catheters and increased ICIQ-SF scores are independent predictors for worse HRQOL outcomes. Furthermore, we show significant beneficial effects of pelvic floor muscle training on patients HRQOL. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e740 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Alexander Kretschmer More articles by this author Tobias Grimm More articles by this author Alexander Buchner More articles by this author Markus Grabbert More articles by this author Maria Apfelbeck More articles by this author Birte-Swantje Schneevoigt More articles by this author Friedrich Jokisch More articles by this author Gerald Schulz More articles by this author Ricarda M. Bauer More articles by this author Christian G. Stief More articles by this author Alexander Karl More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...