Long-term chronological changes in urination status of patients who underwent ileal neobladder reconstruction at a singl
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UROLOGY - ORIGINAL PAPER
Long‑term chronological changes in urination status of patients who underwent ileal neobladder reconstruction at a single institution Takuya Koie1 · Yasuhiro Hashimoto2 · Atsushi Imai3 · Tohru Yoneyama2 · Yuki Tobisawa2 · Toshikazu Tanaka4 · Daisuke Noro5 · Masaaki Oikawa6 · Tadashi Suzuki3 Received: 13 July 2020 / Accepted: 29 August 2020 © Springer Nature B.V. 2020
Abstract Purpose This study aimed to investigate the long-term chronological changes in urination status of patients who underwent radical cystectomy (RC) followed by orthotopic ileal neobladder (ONB) reconstruction using the International Prostatic Symptoms Score (IPSS) and the Overactive Bladder Symptoms Score (OABSS). Methods This retrospective study focused on patients who underwent RC followed by ONB reconstruction and those who consented for IPSS, quality of life (QOL) based on urinary symptoms (IPSS-QOL), and OABSS assessments in the followup period. The patients were divided according to gender into the male group (M-group) and female group (F-group). All patients were evaluated using IPSS, IPSS-QOL, and OABSS every 3 months. The primary endpoint was to assess chronological changes in the urination status of patients who underwent ONB reconstruction after RC. Results The median age of the enrolled patients (n = 122) was 65 years and the median follow-up period was 92.0 months. The median voiding symptom score in IPSS after 10 years of surgery was significantly higher in the M-group than in the F-group. Contrarily, the F-group demonstrated a significantly higher median storage symptom score at 60–66 and 102–114 months than the M-group. The median OABSS scores were relatively higher in the F-group than in the M-group. Conclusions Although long-term urinary function with ONB demonstrated acceptable results, dysfunctional voiding was observed > 10 years after surgery. Thus, the changes in long-term urinary function should be considered when deciding ONB. Keywords Bladder cancer · Ileal neobladder · Urination status · Radical cystectomy · Quality of life
Introduction
* Takuya Koie goodwin@gifu‑u.ac.jp 1
Department of Urology, Gifu University Graduate School of Medicine, 1‑1 Yanagido, Gifu 501‑1194, Japan
2
Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
3
Department of Urology, Oyokyo Kidney Research Institute, Hirosaki, Japan
4
Department of Urology, Aomori Prefectural Central Hospital, Aomori, Japan
5
Department of Urology, Mutsu General Hospital, Mutsu, Japan
6
Department of Urology, Oyokyo Kidney Research Institute, Aomori, Japan
Radical cystectomy (RC) followed by urinary diversion (UD) is a standard treatment option in patients with muscleinvasive bladder cancer (MIBC); however, the mortality rate associated with MIBCs is comparatively lower than with other urological malignancies [1, 2]. Recently, the number of cancer survivors with such malignancies is gradually increasing [3]. Hence, there has been an increasing interest in studying the health-r
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