Effect of nerve-sparing cystectomy on postoperative continence after orthotopic bladder substitution / 中华泌尿外科杂志

ABSTRACT

Objective To examine the effect of nerve sparing cystectomy technique on postoperative continence after orthotopic bladder substitution. Methods A total of 73 consecutive male patients underwent cystectomy and construction of a colonic reservoir with low pressure.Of them nerve sparing were attempted in 48 cases (study group) and non nerve sparing in 25 (control group).The patients were followed up for 3 to 28 months.Postoperative continence was compared between the 2 groups through questionnaires and urinary pad test. Results After removal of the urinary catheter the continence rate was 65% in nerve sparing group and 34% in non nerve sparing group during the day;and it was 40% and 26%,respectively,at night.The mean time from post operation to continence during the day and at night in nerve sparing group was 2 and 4 months,respectively;while it was 5 and 10 months,respectively in non nerve sparing group.Twelve months after operation,the continence rate of nerve sparing group and non nerve sparing group was 96% and 79% during the day;and it was 87% and 64% at night,respectively.Continence differed significantly between the two groups (day, P =0.002;night, P =0.001). Conclusions Nerve sparing cystectomy is associated with improved urinary continence after orthotopic bladder substitution.