Early and Late Urodynamic Assessment of Padua Ileal Bladder

Mariaconsiglia Ferriero, Giuseppe Simone, Andrea Rocchegiani, Maurizio Buscarini, Rocco Papalia, Antonio Alcini, Gerardo Paolo Flammia, Michele Gallucci

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Abstract

Objectives: To report the data from a single series of 46 patients who underwent cystectomy and Padua ileal bladder (PIB) substitution during a 48-month period. Data are lacking concerning the changes in urodynamic characteristics of the orthotopic ileal neobladder. Methods: From January 2002 to April 2003, 46 consecutive male patients underwent radical cystectomy and PIB substitution for muscle-invasive bladder cancer. Uroflowmetry, cystometry, and urethral pressure profilometry were analyzed at 12 and 48 months after surgery. All patients were asked to complete a questionnaire regarding quality of life (the European Organization for Cancer Research and Treatment of Cancer Quality of Life Questionnaire and the bladder cancer-specific module). Results: Of the 46 patients, 8 were lost to follow-up because of cancer-related death. When comparing the 12- and 48-month urodynamic characteristics, no significant changes were observed in cystometric capacity or urethral closing pressure. However, the end-filling pressure, peak flow pressure, and postvoid residual urine volume were significantly lower at the 48-month evaluation (P = .0005, P = .0007, and P = .013, respectively). The number of involuntary contractions at 48 months had increased significantly (P = .0012), and the amplitude of the contractions was comparable (P = .084). The daytime continence rate was 96% and 90% at 12 and 48 months, respectively. The nighttime continence rate was 60% at the 48-month evaluation. The questionnaires about the quality of life highlighted the excellent results. Conclusions: An ileal tone is maintained despite detubularization and most likely prevents enlargement of the neobladder. PIB was revealed to maintain an adequate capacity and low pressure during a 48-month period. The urodynamics results and quality of life support this urinary diversion as a valid treatment option for muscle-invasive bladder cancer.

Original languageEnglish
Pages (from-to)1357-1362
Number of pages6
JournalUrology
Volume73
Issue number6
DOIs
Publication statusPublished - Jun 2009

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ASJC Scopus subject areas

  • Urology

Cite this

Ferriero, M., Simone, G., Rocchegiani, A., Buscarini, M., Papalia, R., Alcini, A., Flammia, G. P., & Gallucci, M. (2009). Early and Late Urodynamic Assessment of Padua Ileal Bladder. Urology, 73(6), 1357-1362. https://doi.org/10.1016/j.urology.2009.01.053