Nocturnal Enuresis in Men With an Orthotopic Ileal Reservoir: Urodynamic Evaluation

“…Rates of complete nighttime continence without any pads are reported to be 45% to 65% [60,61]. In a study based on urodynamic study [58], patients with enuresis had higher pressures, maximal volumes, postvoid residual urine volumes, and rates of positive urine culture, as well as lower maximal urethral pressures, flow rates, and compliance, than did those without enuresis by univariate analysis. However, in the multivariate analysis, only the amplitude of uninhibited contractions and increased postvoid residual volume were associated with enuresis [58].…”

Section: Postoperative Problems and Solutionsmentioning

confidence: 99%

“…In a study based on urodynamic study [58], patients with enuresis had higher pressures, maximal volumes, postvoid residual urine volumes, and rates of positive urine culture, as well as lower maximal urethral pressures, flow rates, and compliance, than did those without enuresis by univariate analysis. However, in the multivariate analysis, only the amplitude of uninhibited contractions and increased postvoid residual volume were associated with enuresis [58]. Increased age was associated with a higher rate of enuresis in some series [51], whereas in other reports, age was not correlated [58].…”

Section: Postoperative Problems and Solutionsmentioning

confidence: 99%

“…However, in the multivariate analysis, only the amplitude of uninhibited contractions and increased postvoid residual volume were associated with enuresis [58]. Increased age was associated with a higher rate of enuresis in some series [51], whereas in other reports, age was not correlated [58]. For treatment of nighttime incontinence, patients are instructed initially to limit their fluid intake after the evening meal, to void before going to sleep, and to set an alarm clock to awaken and void once or twice during the night.…”

Section: Postoperative Problems and Solutionsmentioning

confidence: 99%

“…For treatment of nighttime incontinence, patients are instructed initially to limit their fluid intake after the evening meal, to void before going to sleep, and to set an alarm clock to awaken and void once or twice during the night. Several studies reported that the use of imipramine hydrochloride 25 mg at bedtime decreases nighttime leakage in up to 25% of patients [57,58]. However, nighttime continence can ultimately be achieved with improvement of the patient's voiding pattern.…”

Section: Postoperative Problems and Solutionsmentioning

confidence: 99%

See 2 more Smart Citations

Radical Cystectomy and Orthotopic Bladder Substitution Using Ileum

Park

Ahn

2011

Korean J Urol

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Over the past decade, continent urinary diversion, especially orthotopic bladder substitutions, has become increasingly popular following radical cystectomy for bladder cancer. The ultimate goal of orthotopic bladder substitution is to offer patients the best quality of life, similar to that of patients with native bladders. To achieve that purpose, surgeons should be familiar with the characteristics of good candidates for neobladders, the possible intraoperative and postoperative problems related to the surgery, and the solutions to these problems. Postoperative surveillance and instructions given to the patients also contribute to successful, functional results. Here, we reviewed the indications, pitfalls, and solutions for orthotopic bladder substitutions and the patients' quality of life after surgery. When performed properly, orthotopic continent diversion offers good quality of life with few long-term complications. Therefore, we believe it is the best option for the majority of patients requiring cystectomy.

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Orthotopic bladder substitution: Surgical aspects and optimization of outcomes

2021

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Objectives Orthotopic bladder substitution (OBS) is a management option for urinary diversion in men and women undergoing cystectomy. The aim of the procedure is to provide a functional continent urinary reservoir of adequate capacity, compliance and low pressure. We have provided a narrative review of the existing literature and highlighted areas where improvement and standardization can be recommended. Methods Literature search included database search for publications from January 1970 to November 2020, using keywords including OBS, bladder reconstruction, neobladder, radical cystectomy, robotic cystectomy, intracorporeal neobladder, surgical technique, patient selection and outcomes. Results Due to various factors including indications, operative technique and risk of complications, OBS is an enormous undertaking and commitment for patients, surgeons and health professionals involved in the care pathway. The main considerations for patient selection, the technical elements of the procedure and the rationale behind these are discussed. Previously considered to be a choice for a select few, the inclusion criteria have expanded over the last decade. Similarly, surgical techniques including the choice and configuration of bowel segments, construction of anastomosis and nerve or organ sparing procedures have evolved over the years. Minimally invasive laparoscopic and robotic assisted surgery has added further perspectives to the existing literature on OBS. Understanding the principles of operative techniques and assessing the best evidence to influence patient management is crucial as it has a major impact on clinical outcomes. Peri‐ and post‐operative care, focused on the prevention of complications and morbidity, affects long‐term functional and oncological outcomes, which ultimately dictates the quality of life. Conclusions This concise overview of OBS literature highlights the importance of pre‐operative, peri‐operative, and post‐operative aspects with regards to the optimization of patient care. To achieve the best results, meticulous attention should be paid in all these areas, surgical and multi‐disciplinary. Patient education and counseling, with shared decision making are central to the success of the procedure.

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Nocturnal Enuresis in Men With an Orthotopic Ileal Reservoir: Urodynamic Evaluation

Cited by 23 publications

References 14 publications

Short‐Term Functional and Urodynamic Outcome of W‐ileal Orthotopic Neobladder with Serosa‐Lined Tunneled Uretero‐Ileal Anastomosis

Short‐Term Functional and Urodynamic Outcome of W‐ileal Orthotopic Neobladder with Serosa‐Lined Tunneled Uretero‐Ileal Anastomosis

Radical Cystectomy and Orthotopic Bladder Substitution Using Ileum

Orthotopic bladder substitution: Surgical aspects and optimization of outcomes

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