You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Ureter (including Pyeloplasty) and Bladder Reconstruction (including fistula), Augmentation, Substitution, Diversion II (MP53)1 Sep 2021MP53-14 THE NOVEL URETHRAL FIXATION TECHNIQUE IMPROVES URINARY CONTINENCE RECOVERY IN MEN UNDERGOING OPEN RADICAL CYSTECTOMY AND ILEAL ORTHOTOPIC NEOBLADDER Vincenzo Ficarra, Gianluca Giannarini, Giuseppe Alario, Gabriele Tulone, Marta Rossanese, Giuseppe Mucciardi, Claudio Valotto, and Alchiede Simonato Vincenzo FicarraVincenzo Ficarra More articles by this author , Gianluca GiannariniGianluca Giannarini More articles by this author , Giuseppe AlarioGiuseppe Alario More articles by this author , Gabriele TuloneGabriele Tulone More articles by this author , Marta RossaneseMarta Rossanese More articles by this author , Giuseppe MucciardiGiuseppe Mucciardi More articles by this author , Claudio ValottoClaudio Valotto More articles by this author , and Alchiede SimonatoAlchiede Simonato More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002083.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: We have previously shown that fixing the urethral stump laterally and posteriorly was associated with a significant improvement in early urinary continence (UC) recovery compared to standard vesico-urethral anastomosis after retropubic radical prostatectomy. In this study, we assessed UC recovery and perioperative complications after RC with IONB in men operated on with the novel urethral fixation technique. METHODS: A retrospective cohort of 82 consecutive men undergoing open RC with IONB (Vescica Ileale Padovana) between 07/2013 and 06/2020 was analyzed. A study group of 48 men operated on with the urethral fixation technique was compared with a control group of 34 men receiving standard neovesico-urethral anastomosis. In the study group, the urethral stump was fixed to the dorsal median raphe posteriorly and to the medial portion of levator ani muscle postero-laterally, so as to avoid urethral retraction or deviation, and maintain the urethral sphincter in its natural position in the pelvic floor. UC recovery, defined as 0-1 daily safety pads, and perioperative complications were compared between the two groups. Kaplan-Meier method was used to calculate time to UC recovery, and differences between the two subgroups were assessed with log rank statistic. RESULTS: The two groups were comparable with regard to demographic, clinical and pathological variables. At the median follow-up of 36 months, 42 (87.5%) men in the study, and 22 (64.7%) men in the control group during daytime, and 32 (66.7%) men in the study, and 15 (44.1%) men in the control group during nighttime used 0-1 daily safety pads (p=0.01 and p=0.04, respectively). The 3-, 6-, 12- and 18-month daytime incontinence rate was 35.5%, 20.8%, 12.5% and 12.5% in the study, and 52.9%, 44.1%, 39.7% and 23.8% in the control group, respectively (p=0.02, log rank test). No intraoperative complications were observed in either group. Ninety-day postoperative complications were observed in 14 (29.2%) patients in the study, and in 10 (29.4%) cases in the control group (p=0.77). CONCLUSIONS: In our exploratory study, we observed a significant improvement in daytime and nighttime UC recovery with no increase in perioperative complications using the novel urethral fixation technique compared to the standard neovesical-urethral anastomosis after open RC with IONB. These preliminary data seem to corroborate the hypothesis that maintaining the urethral stump in its correct position in the pelvic floor may improve the probability of an earlier UC recovery after RC with IONB. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e944-e944 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Vincenzo Ficarra More articles by this author Gianluca Giannarini More articles by this author Giuseppe Alario More articles by this author Gabriele Tulone More articles by this author Marta Rossanese More articles by this author Giuseppe Mucciardi More articles by this author Claudio Valotto More articles by this author Alchiede Simonato More articles by this author Expand All Advertisement Loading ...