Feasibility of a pre-operative evaluation before urinary reconstruction surgery in neurourology

Objectives: To describe a concept of standardized preoperative evaluation during a day hospital before surgery for urinary diversion or bladder enlargement in neuro-urology, and to evaluate its feasibility and results.

Methods: All patients suffering from a neurological pathology who benefited from a standardized preoperative evaluation during a dedicated day hospital in our center between 2017 and 2021 were eligible. Data were collected retrospectively from standardized reports. The main judgment criterion was the rate of completion of the examinations and consultations planned during this evaluation. The impact of the standardized assessment on the course of care, through the information collected, the need for additional examinations and the modification of urological management following the standardized assessment, constituted the secondary endpoint.

Results: 131 patients benefited from this standardized evaluation. The overall completeness rate of the data collected was 77.5%, increasing from 62.3% in 2017 to 89.3% in 2021. The urological therapeutic plan was modified for 19.1% of patients following the pre-operative evaluation. The indication was then confirmed for 114 patients (87.0%) by the multidisciplinary meeting, and was carried out unchanged during the following year for 89 patients (67.9%). An associated colostomy procedure was proposed to 18.3% of patients during the standardized evaluation, and was finally performed in 11.5%.

Conclusions: A standardized multidisciplinary preoperative outpatient evaluation before performing reconstructive surgery or urinary diversion in neuro-urology seems feasible and makes it possible to optimize the surgical plan and adapt the course of care.