Long-term functional outcomes after radical cystectomy with ileal bladder substitute : does the definition of continence matter?
(2017) In Scandinavian Journal of Urology 51(1). p.44-49- Abstract
Objective: Functional outcomes after ileal bladder substitution reflect the expectations of future patients at a particular centre. The aim of this study was to use validated questionnaires and a pad-weighing test to investigate functional outcomes after neobladder reconstruction at long-term follow-up in patients at a single centre. Materials and methods: During 2005 − 2015, 75 patients received a Studer ileal bladder substitute at the Department of Urology, Malmö. Forty-six of these patients were alive for follow-up and were evaluated using the pad-weighing test and the International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form (ICIQ-UI-SF), the Female Sexual Function Index (FSFI) and the International... (More)
Objective: Functional outcomes after ileal bladder substitution reflect the expectations of future patients at a particular centre. The aim of this study was to use validated questionnaires and a pad-weighing test to investigate functional outcomes after neobladder reconstruction at long-term follow-up in patients at a single centre. Materials and methods: During 2005 − 2015, 75 patients received a Studer ileal bladder substitute at the Department of Urology, Malmö. Forty-six of these patients were alive for follow-up and were evaluated using the pad-weighing test and the International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form (ICIQ-UI-SF), the Female Sexual Function Index (FSFI) and the International Index of Erectile Function (IIEF). Results: Five of 37 evaluable patients (14%) were considered fully continent, reporting a pad-weighing test result of 0 g and an ICIQ-UI-SF score of 0. The median ICIQ-UI-SF score was 8 [interquartile range (IQR) 3–11], and seven patients (17%) were continent according to the ICIQ-UI-SF score only. In the pad-weighing test, 28 out of 37 patients (76%) reported 0 g day-time leakage whereas only 12 out of 37 patients (32%) reported 0 g night-time leakage. At follow-up, nine out of 39 (23%) of evaluable male patients were potent. The median ICIQ-UI-SF score was significantly lower during the second half of the study period [4 (IQR 0–8) vs 10 (IQR 6–14); p = .003]. The inverse applied to the median IIEF score [5 (IQR 3–12) vs 2 (IQR 1–4); p = .02]. Conclusions: Functional outcomes at long-term follow-up after radical cystectomy and Studer ileal bladder substitute were at best modest in this series. Better outcomes during the second half of the study period might be explained by improved patient selection and a refined surgical technique, but possibly also by longer follow-up of patients during the first half of the period resulting in a more pronounced time-dependent decline in functional outcomes.
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- author
- Liedberg, Fredrik LU ; Ahlgren, Göran LU ; Baseckas, Gediminas ; Gudjonsson, Sigurdur LU ; Håkansson, Ulf LU ; Lindquist, Sara ; Löfgren, Annica LU ; Patschan, Oliver LU ; Siller, Carina and Sjödahl, Gottfrid LU
- organization
- publishing date
- 2017
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Continence, functional outcome, ICIQ-UI-SF, IIEF, neobladder, potency, radical cystectomy
- in
- Scandinavian Journal of Urology
- volume
- 51
- issue
- 1
- pages
- 6 pages
- publisher
- Taylor & Francis
- external identifiers
-
- pmid:27834115
- wos:000393918200008
- scopus:84994810275
- ISSN
- 2168-1805
- DOI
- 10.1080/21681805.2016.1249943
- language
- English
- LU publication?
- yes
- id
- 6f604535-03c5-48f6-a4ed-6e4e707438d5
- date added to LUP
- 2016-11-28 14:28:55
- date last changed
- 2024-03-07 17:02:15
@article{6f604535-03c5-48f6-a4ed-6e4e707438d5,
abstract = {{<p>Objective: Functional outcomes after ileal bladder substitution reflect the expectations of future patients at a particular centre. The aim of this study was to use validated questionnaires and a pad-weighing test to investigate functional outcomes after neobladder reconstruction at long-term follow-up in patients at a single centre. Materials and methods: During 2005 − 2015, 75 patients received a Studer ileal bladder substitute at the Department of Urology, Malmö. Forty-six of these patients were alive for follow-up and were evaluated using the pad-weighing test and the International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form (ICIQ-UI-SF), the Female Sexual Function Index (FSFI) and the International Index of Erectile Function (IIEF). Results: Five of 37 evaluable patients (14%) were considered fully continent, reporting a pad-weighing test result of 0 g and an ICIQ-UI-SF score of 0. The median ICIQ-UI-SF score was 8 [interquartile range (IQR) 3–11], and seven patients (17%) were continent according to the ICIQ-UI-SF score only. In the pad-weighing test, 28 out of 37 patients (76%) reported 0 g day-time leakage whereas only 12 out of 37 patients (32%) reported 0 g night-time leakage. At follow-up, nine out of 39 (23%) of evaluable male patients were potent. The median ICIQ-UI-SF score was significantly lower during the second half of the study period [4 (IQR 0–8) vs 10 (IQR 6–14); p = .003]. The inverse applied to the median IIEF score [5 (IQR 3–12) vs 2 (IQR 1–4); p = .02]. Conclusions: Functional outcomes at long-term follow-up after radical cystectomy and Studer ileal bladder substitute were at best modest in this series. Better outcomes during the second half of the study period might be explained by improved patient selection and a refined surgical technique, but possibly also by longer follow-up of patients during the first half of the period resulting in a more pronounced time-dependent decline in functional outcomes.</p>}},
author = {{Liedberg, Fredrik and Ahlgren, Göran and Baseckas, Gediminas and Gudjonsson, Sigurdur and Håkansson, Ulf and Lindquist, Sara and Löfgren, Annica and Patschan, Oliver and Siller, Carina and Sjödahl, Gottfrid}},
issn = {{2168-1805}},
keywords = {{Continence; functional outcome; ICIQ-UI-SF; IIEF; neobladder; potency; radical cystectomy}},
language = {{eng}},
number = {{1}},
pages = {{44--49}},
publisher = {{Taylor & Francis}},
series = {{Scandinavian Journal of Urology}},
title = {{Long-term functional outcomes after radical cystectomy with ileal bladder substitute : does the definition of continence matter?}},
url = {{http://dx.doi.org/10.1080/21681805.2016.1249943}},
doi = {{10.1080/21681805.2016.1249943}},
volume = {{51}},
year = {{2017}},
}