Objective: To evaluate the factor age at the surgery on long-term postoperative outcomes in patients with postprostatectomy incontinence (PPI) after AdVance XP transobturator male sling implantation. Methods: A total of 115 male patients with PPI, who had undergone AdVance XP sling implantation, were included. Patients had PPI with endoscopically confirmed good sphincteric-contractility and a positive coaptive response. Kruskal-Wallis test with Dunn post-hoc tests were used to analyze the postoperative outcome differences between the patient groups aged less than 66, 66-75, and over greater than 75 years. Outcome measures were the 24 h pad test, the number of daily pads used, the International Consultation on Incontinence Questionnaire short form (ICIQ-SF), International Quality of Life Score (IQOL), Patient Global Impression of Improvement (PGI-I), International Index of Erectile Function-5 (IIEF-5), International Prostate Symptom Score (IPSS), and Visual Analog Scale scores. Observation time points were 3, 6, 12, 24, 36, 48, 60, and 84 months after surgery.Results: Between the age groups, there was no difference in the success rate of the procedure (defined as 0 pads/24 h and less than 5 g in the 24-h pad test) at any point in time. Subjective parameters measures using the ICIQ-SF, PGI-I, IQOL, and IPSS scores showed no differences between the two cohorts. Only erectile function (IIEF-5 score) was lower in older patients in comparison to the cohort aged less than 66 years (p < 0.05 at 3, 6, 12, 24, 36, and 48 months).This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
INTRODUCTION AND OBJECTIVE: Radical cystectomy (RC) is associated with a high risk of infectious complications. This risk does not only apply for the perioperative phase, but also for the long-term. Despite significant morbidity, these complications are inadequately investigated. This is the first prospective study that systematically assesses infectious complications after RC.METHODS: Patients undergoing RC because of oncological and non-oncological indications are prospectively enrolled in this ongoing observational study. Perioperative parameters are assessed at standardized time points and include infectious laboratory parameters (leukocytes, CRP, IL-6, Procalcitonin) as well as microbiological analyses (wound drainage, urine samples). Follow-up examinations are performed 3, 6, and 12 months after surgery and include questionnaires, blood tests, and urosonography. An Ethical Committee approval has been obtained and the study has been registered on ClinicalTrials.gov (NCT05153694).RESULTS: We performed an interim analysis of 50 patients. The median age was 69 years (84% male, 16% female). 40.0% received an ileal conduit (IC) and 60.0% a neobladder (NB). 50.0% of patients presented with a urinary tract infection preoperatively, but only 25.0% reported dysuria. The hospital antibiotic (AB) prophylaxis standard of cefuroxime (5 d) and metronidazole (3 d) was extended in 97.6% of patients. Microbiological analysis of the wound drainage on the 1st postoperative day (POD) showed bacterial growth in 18.2%. The urine culture on the 8th POD was positive in 65.9%. 40.0% had at least one episode of fever (!38 C) during the inpatient stay. The incidence of fever between IC and NB was not significantly different (OR 0.88; p[0.24). Also, there was no significant association between the level of IL-6 on the 1 st POD or the results of the microbiological analyses (wound drainage and urine samples) and the occurrence of fever (p[0.82; p[0.83; p[0.93, respectively). 50.0% reported the intake of at least one AB drug and 31.4% reported an emergency consultation due to RC-associated fever in the first 3 months after surgery, respectively. There was no significant difference between IC and NB for these follow-up results (p[0.17; p[0.55, respectively).CONCLUSIONS: This is the first systematic and comprehensive prospective study assessing infectious complications after RC. Importantly, our preliminary results indicate that these complications are severely underestimated both during the inpatient stay, but also in the long-term.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.