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“Bordeaux Neobladder”: First Evaluation of the Urodynamic Outcomes

BACKGROUND: The intracorporeal orthotopic modified-Y “Bordeaux“ neobladder (iYNB) was first described in 2016. No urodynamic evaluation of this neobladder has yet been performed. OBJECTIVE: To present the urodynamic features of the iYNB and incontinence-specific health-related quality of life (HRQoL...

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Autores principales: Asimakopoulos, Anastasios D., Gubbiotti, Marilena, Agrò, Enrico Finazzi, Morini, Elena, Giommoni, Valentina, Piechaud, Thierry, Gaston, Richard, Annino, Filippo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9791315/
https://www.ncbi.nlm.nih.gov/pubmed/36578286
http://dx.doi.org/10.1016/j.euros.2022.11.010
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author Asimakopoulos, Anastasios D.
Gubbiotti, Marilena
Agrò, Enrico Finazzi
Morini, Elena
Giommoni, Valentina
Piechaud, Thierry
Gaston, Richard
Annino, Filippo
author_facet Asimakopoulos, Anastasios D.
Gubbiotti, Marilena
Agrò, Enrico Finazzi
Morini, Elena
Giommoni, Valentina
Piechaud, Thierry
Gaston, Richard
Annino, Filippo
author_sort Asimakopoulos, Anastasios D.
collection PubMed
description BACKGROUND: The intracorporeal orthotopic modified-Y “Bordeaux“ neobladder (iYNB) was first described in 2016. No urodynamic evaluation of this neobladder has yet been performed. OBJECTIVE: To present the urodynamic features of the iYNB and incontinence-specific health-related quality of life (HRQoL) outcomes. DESIGN, SETTING, AND PARTICIPANTS: We prospectively assessed 26 patients operated between September 2018 and November 2020. SURGICAL PROCEDURE: Robotic radical cystectomy for malignant disease of the bladder and iYNB, performed by a single surgeon, were used. MEASUREMENTS: Three months after surgery and in November 2021, consenting patients underwent clinical evaluation and multichannel urodynamic study (UDS). The incontinence quality of life (I-QoL) questionnaire was used to evaluate HRQoL. Continence was classified into day- and nighttime, and clinically defined as the use of zero pads. A descriptive statistical analysis was performed. RESULTS AND LIMITATIONS: The mean age at surgery was 65.4 yr. The mean follow-up period was 27 mo (12–38). The mean time for the neobladder reconstruction was 192 min (110–340). The mean maximum capacity was 431 cm(3) (range 200–553). The mean postvoid residual was 101.6 ml (0–310), and the rate of clean intermittent catheterization was 17.6%. With the exception of a significant reduction in the volume of the first sensation of bladder fullness, no other statistically significant changes in the UDS parameters of both the storage and the voiding phase were observed over time. Day- and nighttime continence rates were 58.8% and 23.5%, respectively. The mean postoperative I-QoL score was 103.3 (89–110). Limitations include the small number of patients and short follow-up. CONCLUSIONS: The UDS evaluation of iYNB demonstrates that both the volumetric and the pressure characteristics are acceptable and may enhance quality of life. Prospective studies with larger numbers of patients and longer follow-up are needed to further evaluate the iYNB. PATIENT SUMMARY: The “Bordeaux“ neobladder provides acceptable urodynamic outcomes. It is associated with high levels of health-related quality of life and good rates of continence in patients.
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spelling pubmed-97913152022-12-27 “Bordeaux Neobladder”: First Evaluation of the Urodynamic Outcomes Asimakopoulos, Anastasios D. Gubbiotti, Marilena Agrò, Enrico Finazzi Morini, Elena Giommoni, Valentina Piechaud, Thierry Gaston, Richard Annino, Filippo Eur Urol Open Sci Surgery in Motion: Open Science BACKGROUND: The intracorporeal orthotopic modified-Y “Bordeaux“ neobladder (iYNB) was first described in 2016. No urodynamic evaluation of this neobladder has yet been performed. OBJECTIVE: To present the urodynamic features of the iYNB and incontinence-specific health-related quality of life (HRQoL) outcomes. DESIGN, SETTING, AND PARTICIPANTS: We prospectively assessed 26 patients operated between September 2018 and November 2020. SURGICAL PROCEDURE: Robotic radical cystectomy for malignant disease of the bladder and iYNB, performed by a single surgeon, were used. MEASUREMENTS: Three months after surgery and in November 2021, consenting patients underwent clinical evaluation and multichannel urodynamic study (UDS). The incontinence quality of life (I-QoL) questionnaire was used to evaluate HRQoL. Continence was classified into day- and nighttime, and clinically defined as the use of zero pads. A descriptive statistical analysis was performed. RESULTS AND LIMITATIONS: The mean age at surgery was 65.4 yr. The mean follow-up period was 27 mo (12–38). The mean time for the neobladder reconstruction was 192 min (110–340). The mean maximum capacity was 431 cm(3) (range 200–553). The mean postvoid residual was 101.6 ml (0–310), and the rate of clean intermittent catheterization was 17.6%. With the exception of a significant reduction in the volume of the first sensation of bladder fullness, no other statistically significant changes in the UDS parameters of both the storage and the voiding phase were observed over time. Day- and nighttime continence rates were 58.8% and 23.5%, respectively. The mean postoperative I-QoL score was 103.3 (89–110). Limitations include the small number of patients and short follow-up. CONCLUSIONS: The UDS evaluation of iYNB demonstrates that both the volumetric and the pressure characteristics are acceptable and may enhance quality of life. Prospective studies with larger numbers of patients and longer follow-up are needed to further evaluate the iYNB. PATIENT SUMMARY: The “Bordeaux“ neobladder provides acceptable urodynamic outcomes. It is associated with high levels of health-related quality of life and good rates of continence in patients. Elsevier 2022-12-15 /pmc/articles/PMC9791315/ /pubmed/36578286 http://dx.doi.org/10.1016/j.euros.2022.11.010 Text en © 2022 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Surgery in Motion: Open Science
Asimakopoulos, Anastasios D.
Gubbiotti, Marilena
Agrò, Enrico Finazzi
Morini, Elena
Giommoni, Valentina
Piechaud, Thierry
Gaston, Richard
Annino, Filippo
“Bordeaux Neobladder”: First Evaluation of the Urodynamic Outcomes
title “Bordeaux Neobladder”: First Evaluation of the Urodynamic Outcomes
title_full “Bordeaux Neobladder”: First Evaluation of the Urodynamic Outcomes
title_fullStr “Bordeaux Neobladder”: First Evaluation of the Urodynamic Outcomes
title_full_unstemmed “Bordeaux Neobladder”: First Evaluation of the Urodynamic Outcomes
title_short “Bordeaux Neobladder”: First Evaluation of the Urodynamic Outcomes
title_sort “bordeaux neobladder”: first evaluation of the urodynamic outcomes
topic Surgery in Motion: Open Science
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9791315/
https://www.ncbi.nlm.nih.gov/pubmed/36578286
http://dx.doi.org/10.1016/j.euros.2022.11.010
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