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Long-term functional outcomes after radical cystectomy with ileal bladder substitute : does the definition of continence matter?

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 (2017) In Scandinavian Journal of Urology2013-01-01+01:00 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
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Continence, functional outcome, ICIQ-UI-SF, IIEF, neobladder, potency, radical cystectomy
in
Scandinavian Journal of Urology2013-01-01+01:00
volume
51
issue
1
pages
6 pages
publisher
Taylor & Francis
external identifiers
  • scopus:84994810275
  • wos:000393918200008
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
2018-03-18 05:06:40
@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},
  keyword      = {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 Urology2013-01-01+01:00},
  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},
  volume       = {51},
  year         = {2017},
}