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Urodynamic assessment and quality of life outcomes of robot-assisted totally intracorporeal radical cystectomy and orthotopic neobladder for bladder cancer: a preliminary study

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Abstract

Purpose

Few data exist regarding the functional outcomes of robot-assisted radical cystectomy (RARC) with intracorporeal orthotopic neobladder. The aim of this study was to evaluate the urodynamic and functional outcomes in patients undergoing RARC and totally intracorporeal orthotopic neobladder for bladder cancer.

Methods

In this monocentric, observational study carried out between 2016 and 2020, consecutive patients undergoing RARC and intracorporeal orthotopic neobladder in the Department of Urology, Pitié-Salpêtrière Hospital, were included. Reconstruction was totally intracorporeal Y-shaped neobladder. Main outcomes were urodynamic findings 6 months post-surgery, continence and quality of life (QoL). Continence was defined by no pad or one safety pad. International Consultation on Incontinence Questionnaire (ICIQ), International Index of Erectile Function questionnaire (IIEF-5) and Bladder Cancer Index (BCI) scores were recorded.

Results

Fourteen male patients were included (median age: 64 years [IQR 54–67]. Median maximal neobladder cystometric capacity was 495 ml [IQR 410–606] and median compliance was 35.5 ml/cm H2O [IQR 28–62]. All patients had post-void residual volume < 30 ml, except for three (22%) who required clean intermittent-self catheterisation. Daytime continence was achieved in 10 patients (71%) and night-time continence in two (14.3%). Median ICIQ score was 7 [IQR 5–11]. Postoperative erectile function was present in 7% of patients (mean IIEF-5 = 5 [IQR 2–7]). Thirteen patients (93%) were satisfied with their choice of neobladder.

Conclusion

RARC with totally intracorporeal orthotopic neobladder for bladder cancer provides satisfactory urodynamic results and good QoL. These findings should be confirmed long-term.

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Funding

There are no funding sources to report for this study.

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Author notes

  1. Elisabeth Grobet-Jeandin, Daniel Benamran, and Véronique Phé contributed equally to this study.

Authors and Affiliations

  1. Division of Urology, Geneva University Hospitals, Geneva, Switzerland

    Elisabeth Grobet-Jeandin & Daniel Benamran

  2. Department of Urology, Sorbonne Université, GRC n°5, Predictive Onco-urology, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France

    Elisabeth Grobet-Jeandin, Daniel Benamran, Ugo Pinar, Jeanne Beirnaert, Jérôme Parra, Christophe Vaessen, Thomas Seisen & Morgan Rouprêt

  3. Service d’Urologie, Hôpital Erasme, Cliniques Universitaires de Bruxelles, Brussels, Belgium

    Jeanne Beirnaert

  4. Department of Urology, Sorbonne Université, GRC n°5, Predictive Oncology, Assistance Publique-Hôpitaux de Paris, AP-HP Sorbonne Université, Tenon Hospital, 4 rue de la Chine, 75020, Paris, France

    Véronique Phé

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  1. Elisabeth Grobet-Jeandin
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Contributions

EG-J: conception and design, acquisition of data, analysis and interpretation of data, drafting of the manuscript, statistical analysis. DB: conception and design, acquisition of data, analysis and interpretation of data, drafting of the manuscript, statistical analysis. UP: acquisition of data, analysis and interpretation of data, drafting of the manuscript, statistical analysis. JB: acquisition of data, statistical analysis. JP: acquisition of data, critical revision. CV: acquisition of data, critical revision. TS: acquisition of data, critical revision. MR: conception and design, analysis and interpretation of data, drafting of the manuscript, critical revision, supervision. VP: conception and design, analysis and interpretation of data, drafting of the manuscript, critical revision, supervision.

Corresponding author

Correspondence to Véronique Phé.

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The authors have no potential conflicts of interest to report.

Ethical approval

This study was approved by the Institutional Review Board of Hôpital Pitié Salpêtrière (APHP) and was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments.

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All patients gave their written informed consent before taking part.

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Grobet-Jeandin, E., Benamran, D., Pinar, U. et al. Urodynamic assessment and quality of life outcomes of robot-assisted totally intracorporeal radical cystectomy and orthotopic neobladder for bladder cancer: a preliminary study. World J Urol 40, 2535–2541 (2022). https://doi.org/10.1007/s00345-022-04126-9

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