Aims: To identify the definition for urinary continence (UC) after radical prostatectomy (RP) which reflects best patients' perception of quality of life (QoL). Methods: Continence was prospectively assessed in 634 patients, 12 months after RP using the International Consultation on Incontinence Questionnaire Short-Form (ICIQ-SF) and the number of pads employed in a 24-hour period (pad usage). We used the one-way ANOVA technique with posthoc pairwise comparisons according to Scheffé's method (homogeneous subsets) for assessing the degree of QoL deficit related to urinary incontinence (UI). Results: The continence prevalence is 64.4%, 74.1%, 88.3%, and 35.8% using "0 pads," "1 safety pad," "1 pad," and "ICIQ score 0" definitions, respectively. Pad usage is moderately strongly associated with ICIQ 1, 2, and 3 (ρ = 0.744, 0.677, and 0.711, respectively; p < 0.001). Concordance between classical UC definitions is acceptable between "0 pads-ICIQ score 0" (K = 0.466), but poor for "1 safety pad" and "1 pad" (K = 0.326 and 0.137, respectively). Patients with "0 pad usage" have better QoL related to urine leakage than patients with "1 safety pad" or "1 pad" (1.41 vs. 2.44 and 3.11, respectively; p < 0.05). There were no significant differences found regarding QoL between patients with ICIQ score 0 and ICIQ score 2 (1.01 vs. 1.63; p = 0.63). Conclusions: Pad usage and the ICIQ-SF's answers provide useful information. We propose a combined definition (0 pads and ICIQ score ≤2) as it is the definition with the least impact on daily QoL.
Introduction: There are multiple causes of end-stage renal disease (ESRD). One of the most uncommon
cause is the obstruction of the lower urinary tract due to the development of new endourological procedures
and the improvement in clean intermittent catheterization. However, urodynamic problems that require
solutions to bladder problems continue to appear that will directly affect the function of the kidney graft.
Objective: Clearly state the possibility of performing a bladder conduit technique at the same time as a
kidney transplant as an option for patients who undergo kidney transplantation with incompetent bladders.
A clinical case is described as an example.
Material and Methods: The clinical case of a patient with left cutaneous ureterostomy due to neurogenic
bladder who is a candidate for renal transplant is presented. An ileal conduit type urinary diversion is
performed in the same surgical act as the renal transplant. The existing literature is analyzed in relation to
the different types of urinary diversion and how they affect renal function.
Clinical Case and Results: Here we present a 50-year-old male with hypotonic bladder since 19th years old
secondary to sacral lipectomy. He developed a progressive deterioration of renal function until he started
hemodialysis program in 2018. Ileal conduit and renal transplant are performed through right pararectal
incision, reimplantation of the ureter in the antimesenteric side of the intestinal loop. No increase of
complications was observed in the post-transplant. The patient was discharged the 7th day after surgery.
Serum creatinine at 6 months after renal transplantation 1.2mg/dl.
Conclusion: Ileal conduit is a valid resource in patients with neurogenic bladders or with emptying
problems whose solution puts at risk the functionality of the graft. Similar recovery is observed in time
compared to a kidney transplant without ileal shunt. Post-transplant graft function was good without an
increase in complications.
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.