You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Ureter (including Pyeloplasty) and Bladder Reconstruction (including fistula), Augmentation, Substitution, Diversion II1 Apr 2017PD38-09 PROSPECTIVE EVALUATION OF CONTINENCE FOLLOWING OPEN RADICAL CYSTECTOMY AND ORTHOTOPIC URINARY DIVERSION AND THE EFFECT OF PELVIC FLOOR PHYSICAL THERAPY Soroush Bazargani, Thomas Clifford, eileen Johnson, Kevin Wayne, Gus Miranda, Jie Cai, Hooman Djaladat, Anne Schuckman, and siamak Daneshmand Soroush BazarganiSoroush Bazargani More articles by this author , Thomas CliffordThomas Clifford More articles by this author , eileen Johnsoneileen Johnson 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.2017.02.1723AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We evaluated the continence outcomes in patients undergoing orthotopic neobladder (ONB) diversion following radical cystectomy (RC) using validated pad usage questionnaires and in a subgroup who underwent pelvic floor physical therapy (PFPT). METHODS Under IRB approval, we identified 1269 patients that underwent open RC from 2002 to 2015 (ONB 74%, 85% male). From 2012, patients were prospectively followed with a validated, pictorial pad usage questionnaire. A subgroup of patients received PFPT as an intervention to assist their continence. Interventions focused on improving pelvic floor muscle strength and coordination. Manual, visual and surface EMG biofeedback training were incorporated to improve neuromuscular re-education of the pelvic floor as well as behavioral modifications for bladder re-training, timed voiding and general bladder and bowel health. Frequency of visits started from 1x/week over 4-6 sessions, and longer thereafter. RESULTS A total of 153 male patients with available pad usage questionnaires were followed from September 2012 to August 2015. Daytime continence rates increase from 59% at <3 months to 92% by 12-18 months postoperatively. Nighttime continence rates increased to 51% by 18-36 months postoperatively. Overall catheterization rate was 13.1%. 17 patients underwent PFPT during this period, with a median age of 70 yrs. There was no significant difference between groups for age, BMI, or Charlson comorbidity index. Univariate analysis showed there is a shorter median time to first daytime continence in PFPT group compared to non-intervention group (89 days vs 182 days respectively; p=0.06), while this was not significant for the nighttime continence (median 134 vs 311; p=0.12). Kaplan Meier curves also showed higher continence rates in PFPT group at 1 year (0.710.13) compared to non-PFPT ones (0.60.04), although the difference was not significant (p=0.25) (figure 1). CONCLUSIONS Following ONB, continence improves significantly by 6 months, and plateaus with 92% of patients achieving daytime continence by 12-18 months. Those who received PFPT tend to have faster return to daytime continence in the first year. Further research with bigger sample size is needed to support the value of PFPT in continence after RC and ONB. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e742-e743 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Soroush Bazargani More articles by this author Thomas Clifford More articles by this author eileen Johnson 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 ...