Functional Outcome and Complications following Ileal Neobladder Reconstruction in Male Patients without Tumor Recurrence. More than 35 Years of Experience from a Single Center

Hautmann, Richard E.; Volkmer, Björn; Egghart, G; Frohneberg, D.; Gottfried, Hans‐Werner; Gschwend, Jürgen E.; Hefty, R.; Kleinschmidt, K.; Küfer, R.; Miller, Kurt; Petriconi, R. de; Simon, J.; Wenderoth, U. K.

doi:10.1097/ju.0000000000001345

Cited by 25 publications

(17 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A recent study by Hautmann et al found that among its 259 patients who received an OUD over the last 35 years, serum creatinine showed only age-related increase [24 ▪▪ ]. Overall, no robust and comparative data exists that shows that OUDs lead to worse renal functional outcomes when compared with other urinary diversions.…”

Section: Discussionmentioning

confidence: 99%

Orthotopic urinary diversions after radical cystectomy for bladder cancer: lessons learned last decade

Janssen

Ramkumar

Lee

et al. 2021

Current Opinion in Urology

View full text Add to dashboard Cite

Purpose of reviewOrthotopic urinary diversion (OUD), or neobladder, is believed to be the gold standard for surgical bladder reconstruction following radical cystectomy though it is performed far less often than ileal conduits. As both a continent and intracavitary diversion, OUDs offer unique advantages for patients. Their utilization has decreased overall though, especially with the advent of robotic surgery. In this review, we will cover patient selection for OUD, functional outcomes (i.e., continence, sexual activity, quality of life [QoL]), and robotic orthotopic diversions. Recent findingsOUDs have seen a proportionally greater decline in utilization compared with ileal conduits as the number of robotic radical cystectomies being performed with intracorporeal diversions increases. Multiple robotic series have demonstrated less perioperative blood loss and shorter hospital stays when compared with the open approach though operative times are longer, the learning curve is steeper, and overall costs may be higher in some settings. Perioperative safety and short-term oncological outcomes appear comparable. Since robotic OUDs are relatively new, functional outcomes are not yet well established. Patient satisfaction with urinary diversion is associated with informed decision-making tailored to the patient. A thorough understanding of expected short-and long-term functional outcomes and the care required to maintain an OUD improves QoL and satisfaction with diversion choice. SummaryGiven the potential advantages of OUD, its decreasing use is a remarkable trend. Shared decision-making and a patient-centered approach should be used when selecting the type of urinary diversion.

show abstract

Section: Discussionmentioning

confidence: 99%

Orthotopic urinary diversions after radical cystectomy for bladder cancer: lessons learned last decade

Janssen

Ramkumar

Lee

et al. 2021

Current Opinion in Urology

View full text Add to dashboard Cite

show abstract

“…Lin et al [28] use a hybrid approach by performing a RARC, extracorporeal creation of the neobladder, and laparoscopic urethra-neobladder anastomosis with 90% daytime and 82% nighttime continence [Table 2]. Despite this, there is a paucity of data on the functional outcomes for extracorporeal urinary diversion after RARC, however, daytime rates in the larger open studies range from 54%-99% daytime continence 36%-84.6% nighttime continence [12,[31][32][33][34][35] .…”

Section: Functional Outcomesmentioning

confidence: 99%

Review of intracorporeal and extracorporeal continent urinary diversion - where do we stand in 2021?

Balzano¹,

Chan²

2021

Mini-invasive Surg

View full text Add to dashboard Cite

Robot-assisted radical cystectomy has become widely accepted as a safe and minimally invasive procedure for the treatment of bladder cancer. The urinary diversion continues to be performed completely intracorporeally or extracorporeally. Over the past decade, there has been an increasing number of continent diversions being performed intracorporeally. We evaluated the most recent literature regarding intraoperative metrics and outcomes that compare the intracorporeal and extracorporeal approaches.

show abstract

“…The 35-year experience of one of the pioneers in orthotopic bladders substitution, Dr. Richard Hautmann, is presented in this study from Germany (page 174). 12 Of 1,598 patients who underwent cystectomy during that time frame 889 (72.5%) had an ileal neobladder and 87% were able to void spontaneously. Daytime continence was achieved in 90% (pad-free 71%) and nocturnal continence was present in 82% (pad-free 47%).…”

Section: Single Center Experience With Ileal Neobladdermentioning

confidence: 99%

This Month in Adult Urology

Smith¹

2021

Journal of Urology

View full text Add to dashboard Cite

Medicine and society changed in early 2020. Worldwide shutdowns because of COVID-19 affected life for everyone but had a particular impact on hospitals and patients. The Journal of UrologyÒ chronicled many of the important changes that occurred from use of telemedicine, remote learning and proper allocation of hospital resources. Further, multiple publications in The Journal and elsewhere described methods for appropriate triage of nonCOVID patients and, in particular, performance of nonurgent or emergent surgery. These comments are being prepared months before the publication date for this issue which will be the first of the new year. What further impact COVID-19 or other unanticipated problems will have is very difficult to predict. One hopes, though, that important lessons have been learned.This issue of The Journal features a critical evaluation by Cohn et al (page 241) of scoring systems commonly used for prioritization of elective urological surgery during the pandemic. 1 Some methods relied on complex formulas, others consensus expert opinion, and still others used surgeon based scoring. None was validated and all were rapidly put into place. The study shows that the different systems result in substantially different prioritization. A sober analysis of the strengths and weaknesses of each system can help planning for future needs.

show abstract

Functional Outcome and Complications following Ileal Neobladder Reconstruction in Male Patients without Tumor Recurrence. More than 35 Years of Experience from a Single Center

Cited by 25 publications

References 0 publications

Orthotopic urinary diversions after radical cystectomy for bladder cancer: lessons learned last decade

Orthotopic urinary diversions after radical cystectomy for bladder cancer: lessons learned last decade

Review of intracorporeal and extracorporeal continent urinary diversion - where do we stand in 2021?

This Month in Adult Urology

Contact Info

Product

Resources

About