The impact of prior prostatic surgery on urinary continence in patients undergoing orthotopic ileal neobladder
Int. braz. j. urol
;
29(6): 502-506, Nov.-Dec. 2003. tab
Artigo
em Inglês
| LILACS
| ID: lil-364404
RESUMO
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 ANDMETHODS:
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 percent (8 out of 62 patients). The only statistically significant factor that impacted upon urinary continence was previous prostatic surgery, with respectively 33 percent versus 7 percent rate of incontinence for patients previously operated on and for those without previous operation (p = 0.023 odds ratio = 6.5, 95 percent confidence interval). Preservation of prostatic apex did not reach difference, 12 percent versus 13 percent, 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.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Idioma:
Inglês
Revista:
Int. braz. j. urol
Assunto da revista:
Urologia
Ano de publicação:
2003
Tipo de documento:
Artigo
País de afiliação:
Brasil
Instituição/País de afiliação:
Federal University of Sao Paulo/BR
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