The impact of prior prostatic surgery on urinary continence in patients undergoing orthotopic ileal neobladder

The impact of prior prostatic surgery on urinary continence in patients undergoing orthotopic ileal neobladder

Author Arruda, Homero O. De Autor UNIFESP Google Scholar
Suarez, Rubens Autor UNIFESP Google Scholar
Srougi, Miguel Autor UNIFESP Google Scholar
Paula, Adriano A. De Autor UNIFESP Google Scholar
Cury, José Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract OBJECTIVE: To establish if previous surgery for benign prostatic hyperplasia (transurethral resection of the prostate or open prostatectomy), age, and preservation of prostatic apex can influence postoperative urinary continence in patients submitted to radical cystectomy and orthotopic ileal neobladder. PATIENTS AND METHODS: We analyzed 62 patients with bladder cancer who were treated with radical cystectomy and orthotopic ileal neobladder between 1987 and 1998 and had been followed for at least 24 months. The average age and median follow up were 61 years and 53 months, respectively. Postoperative urinary continence was correlated with 3 factors: patient age, preservation of prostatic apex during surgical excision and prior prostatic surgery for benign disease. Patients were defined as incontinent when they had to use more than 1 protective pad at the daytime. RESULTS: The overall incidence of urinary incontinence was 12.9% (8 out of 62 patients). The only statistically significant factor that impacted upon urinary continence was previous prostatic surgery, with respectively 33% versus 7% rate of incontinence for patients previously operated on and for those without previous operation (p = 0.023 odds ratio = 6.5, 95% confidence interval). Preservation of prostatic apex did not reach difference, 12% versus 13%, for those with and without preservation, and age also did not influence the postoperative continence rate. CONCLUSIONS: Prior prostatic surgery for benign prostatic hyperplasia probably can increases the risk for postcystectomy incontinence and preservation of prostate apex did not affect the continence rate. This issue deserves to be considered by the surgeon and must be discussed previously with the patients when planning an orthotopic bladder replacement.
Keywords bladder
bladder neoplasms
urinary diversion
urinary reservoirs
continence
Language English
Date 2003-12-01
Published in International braz j urol. Sociedade Brasileira de Urologia, v. 29, n. 6, p. 502-506, 2003.
ISSN 1677-5538 (Sherpa/Romeo)
Publisher Sociedade Brasileira de Urologia
Extent 502-506
Origin http://dx.doi.org/10.1590/S1677-55382003000600004
Access rights Open access Open Access
Type Article
SciELO ID S1677-55382003000600004 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/1902

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