MP46-13: Robot assisted radical cystectomy with intracorporeal padua ileal neobladder: Long-term functional outcomes and continence predictors assessment from a high-volume center large consecutive series
Introduction: Daytime urinary continence recovery following robot assisted radical cystectomy with intracorporeal orthotopic neobladder (RARC-iON) has been poorly investigated.In this study we reported long-term functional outcomes of RARC-iON and assessed the predictors of daytime urinary continence recovery. Methods: Our single center IRB approved bladder cancer database was queried for “RARC” and “iON”.All patients treated between January 2012 and September 2020,with a minimum 1-yr follow-up were included.Baseline demographic, clinical, perioperative and pathologic data were reported.Functional outcomes included: renal function modification over time,neobladder stone formation,development of uretero-ileal anastomosis strictures,need for self-catheterization and Trifecta achievement(defined as the coexistence of daytime continence, Clavien-Dindo =3 complication-free and recurrence-free status,all assessed at 1 year).Day- and night-time continence recovery probabilities were assessed with Kaplan-Meier method;univariable and multivariable analyses were performed to identify predictors of day-time continence. Results: Overall,192 patients were included,146 were male (76%).Mean baseline eGFR was 83.5 ml/min (± 23.5). At a median follow- up of 41 months (IQR 21-60), mean last eGFR was 63.8 ml/min (± 22.1).The incidence of significant renal function deterioration (newly onset CKD stage =3b) was 16.1%.Neobladder stones were reported in 16 patients (8.3%), all of which successfully treated as outpatient endoscopic procedure.Incidence of ureteroileal anastomosis stricture was 22.4%.Trifecta was achieved in 64.1% of cases.One-yr day- and night-time continence rates were 78.6 % and 48.3 %, respectively. At multivariable analysis age, female gender and severe 30-d complications occurrence were identified as independent predictors of lower day-time continence recovery probabilities. Conclusions: We reported functional outcomes of a large single center consecutive series of RARC-iON. Male, young and those patients who did not experience severe perioperative complications had significantly higher likelihood of recovering daytime urinary continence. SOURCE OF Funding: none
