Correlation between urodynamic function and 3D cat scan anatomy in neobladders: Does it exist?

Crivellaro, Simone; Mami, E; Wald, Christoph; Smith, Jordan; Kocjancic, Ervin; Stoffel, John T.; Bresette, John F.; Libertino, John A.

doi:10.1002/nau.20621

Cited by 8 publications

(9 citation statements)

References 12 publications

(9 reference statements)

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“…Once the posterior plate is created robotically, it is rotated anticlockwise by 908 before urethra-neobladder anastomosis, followed by double cross-folding and true globularization of the neobladder. Our globular robotic iONBs achieved a mean cystometric volume of 514 cm 3 (range 339-1001), which is consistent with mean volumes reported for open ONB series of 430-600 and 450-524 cm 3 for Hautmann [24,25] and Studer [26][27][28] configurations, respectively. Furthermore, the ability to achieve high volumes at low pressure (high compliance) of the robotic iONB lends support to a lowpressure reservoir.…”

Section: Discussionsupporting

confidence: 86%

Robotic Intracorporeal Orthotopic Neobladder: Urodynamic Outcomes, Urinary Function, and Health-related Quality of Life

et al. 2016

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Section: Discussionsupporting

confidence: 86%

Robotic Intracorporeal Orthotopic Neobladder: Urodynamic Outcomes, Urinary Function, and Health-related Quality of Life

et al. 2016

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“…These results support the hypothesis that a 'stable' neobladder and neobladder neck are important factors for continence in patients with neobladder. Our finding that incontinent patients are characterized by a significantly lower position of the neobladder in the pelvis is in line with the results of Crivellaro et al [16] . Altogether, these results are well in agreement with the integral theory of Petros, according to which pelvic floor integrity is a prerequisite for continence [22] .…”

Section: Discussionsupporting

confidence: 94%

“…One of these studies showed that the location of the neobladder neck in the pelvis has an important impact on voiding: in patients showing good void competence the neobladder neck is located at the most caudal portion of the pouch [17] . Moreover, the position of the neobladder relative to the right femur head showed a linear correlation to continence status [16] . In addition, a wide funneling seems to be necessary for successful micturition [9] .…”

Section: Discussionmentioning

confidence: 91%

“…Several imaging studies used computed tomography and static MRI to evaluate postoperative anatomy and functional aspects of the neobladder [9,[15][16][17][18] . One of these studies showed that the location of the neobladder neck in the pelvis has an important impact on voiding: in patients showing good void competence the neobladder neck is located at the most caudal portion of the pouch [17] .…”

Section: Discussionmentioning

confidence: 99%

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Real-Time MRI of Continent and Stress Incontinent Male Patients after Orthotopic Ileal Neobladder

et al. 2011

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Introduction: The aim of this study was to correlate anatomic differences with continence status in male patients after cystoprostatectomy and ileal neobladder using real-time magnetic resonance imaging. Patients and Methods: Anatomic differences of 14 male patients (7 daytime continent and 7 stress incontinent) with ileal neobladder were determined by measuring the orthogonal distance of the bladder neck to the pubococcygeal line (PCL) to correlate anatomic differences with continence status. Results: The median distance of the bladder neck to PCL was +5.4 mm in continent patients before voiding whereas in incontinent patients it was +2 mm (p = 0.012). During the Valsalva maneuver, the median distance in continent patients was +4 and in incontinent patients –3 mm (p = 0.003). At the end of micturition, the median distance was +2.3 mm in continent patients and –12 mm in incontinent patients (p = 0.002). Conclusions: The bladder neck in incontinent patients showed more pronounced mobility in relation to the PCL during micturition and the Valsalva maneuver as compared to continent patients. In addition, the ileal neobladder was positioned significantly lower in the pelvis of incontinent patients. These preliminary results suggest that a stable bladder neck may be an important factor to reach full continence in patients with ileal neobladder.

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“…Comorbidities were reported in eight studies [7,8,13,30,37,53,64,65]. Time of follow-up is reported in 44 (74.6%) studies, but in 15 (23.4%) studies, this data is lacking [7,9,19,23,32,36,39,41,43,46,48,51,53,60,61]. Follow-up ranges from a minimum of 5 months [35] to 179.2 months [31], for a mean value of 42.7 months and a median value of 32.9 (25-75th percentile: 19 to 60.5 months).…”

Section: General Aspectsmentioning

confidence: 99%

Urodynamic Parameters and Continence Outcomes in Asymptomatic Patients with Ileal Orthotopic Neobladder: A Systematic Review and Metanalysis

Asimakopoulos,

Finazzi Agrò,

Piechaud

et al. 2024

Cancers

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Introduction: The orthotopic neobladder is the type of urinary diversion (UD) that most closely resembles the original bladder. However, in the literature the urodynamic aspects are scarcely analysed. Objective: To provide the first systematic review (SR) on the urodynamic (UDS) outcomes of the ileal orthotopic neobladders (ONB). Continence outcomes are also presented. Methods: A PubMed, Embase and Cochrane CENTRAL search for peer-reviewed studies on ONB published between January 2001–December 2022 was performed according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. Results and Conclusion: Fifty-nine manuscripts were eligible for inclusion in this SR. A great heterogeneity of data was encountered. Concerning UDS parameters, the pooled mean was 406.2 mL (95% CI: 378.9–433.4 mL) for maximal (entero)cystometric capacity (MCC) and 21.4 cmH2O (95% CI: 17.5–25.4 cmH2O) for Pressure ONB at MCC. Postvoid-residual ranged between 4.9 and 101.6 mL. The 12-mo rates of day and night-time continence were 84.2% (95% CI: 78.7–89.1%) and 61.7% (95% CI: 51.9–71.1%), respectively.Despite data heterogeneity, the ileal ONB seems to guarantee UDS parameters that resemble those of the native bladder. Although acceptable rates of daytime continence are reported the issue of high rates of night-time incontinence remains unsolved. Adequately designed prospective trials adopting standardised postoperative care, terminology and methods of outcome evaluation as well as of conduction of the UDS in the setting of ONB are necessary to obtain homogeneous follow-up data and to establish UDS guidelines for this setting.

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Correlation between urodynamic function and 3D cat scan anatomy in neobladders: Does it exist?

Abstract: The study seems to show no significant anatomical or functional difference among the three different types of neobladders. A possible correlation between the position of the neobladder and urinary incontinence is suggested, recognizing further study in a larger population is required.

Cited by 8 publications

References 12 publications

Robotic Intracorporeal Orthotopic Neobladder: Urodynamic Outcomes, Urinary Function, and Health-related Quality of Life

Robotic Intracorporeal Orthotopic Neobladder: Urodynamic Outcomes, Urinary Function, and Health-related Quality of Life

Real-Time MRI of Continent and Stress Incontinent Male Patients after Orthotopic Ileal Neobladder

Urodynamic Parameters and Continence Outcomes in Asymptomatic Patients with Ileal Orthotopic Neobladder: A Systematic Review and Metanalysis

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