Formal sacrocolpopexy reduces hypercontinence rates in female neobladder formation Journal Article


Authors: Stearns, G.; Donahue, T.; Fathollahi, A.; Dalbagni, G.; Sandhu, J.
Article Title: Formal sacrocolpopexy reduces hypercontinence rates in female neobladder formation
Abstract: Aims: Continent urinary diversion is preferred by some patients and orthotopic urinary diversion (OUD) has become the procedure of choice for most men following cystectomy for invasive bladder cancer. OUD in women, however, is less common, likely due to a high rate of hypercontinence (HC), potentially from lax support of pelvic structures similar to pelvic organ prolapse. As such, we evaluated if abdominal sacrocolpopexy (ASC) at the time of OUD in women led to decreased rates of HC. Methods: A retrospective review of all female patients receiving OUD by a single surgeon and ASC was performed. ASC was performed after RC was complete prior to the urethro-enteric anastomosis. Peritoneal flap was created to the vaginal apex. The distal leaf was then sutured to the proximal anterior vaginal wall and apex and the proximal end sutured to the anterior longitudinal ligament. HC was defined as the need to perform intermittent catheterization (IC) due to incomplete emptying of the neobladder. Results: Nine women underwent cystectomy with OUD and concurrent ASC during the specified time period. Average patient age was 54 years (27-69). Mean followup was 61.6 months (5-123 months). None of those who underwent ASC had HC or incontinence post-operatively. No mesh-related complications were noted in this cohort. Pelvic abscess was noted in one patient who underwent ASC with rectus fascia. Conclusions: ASC at the time of radical cystectomy and OUD is safe and effective. It appears to be associated with decreased rates of HC and is associated with minimal additional morbidity to the patient. © 2018 Wiley Periodicals, Inc.
Keywords: urinary diversion; bladder; hypercontinence
Journal Title: Neurourology and Urodynamics
Volume: 37
Issue: 7
ISSN: 0733-2467
Publisher: Wiley Liss, Inc  
Date Published: 2018-09-01
Start Page: 2281
End Page: 2285
Language: English
DOI: 10.1002/nau.23584
PROVIDER: scopus
PUBMED: 29664125
DOI/URL:
Notes: Article -- Export Date: 1 October 2018 -- Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Jaspreet Sandhu
    138 Sandhu
  2. Guido Dalbagni
    325 Dalbagni
  3. Timothy Francis Donahue
    72 Donahue