Urinary tract infections in patients with orthotopic neobladder

Mano, Roy; Baniel, Jack; Goldberg, Hanan; Stabholz, Yariv; Kedar, Daniel; Yossepowitch, Ofer

doi:10.1016/j.urolonc.2013.07.017

Cited by 33 publications

(22 citation statements)

References 24 publications

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“…In the present study, we examined 236 patients who underwent radical cystectomy and ileal neobladder. Although febrile UTI occurred in a significant proportion of patients who underwent radical cystectomy and neobladder reconstruction, most febrile UTIs developed in the early postoperative period, a finding consistent with previous studies ( 8 11 ). The observed decline in the incidence of UTI over time after surgery might make UTI seem less important at long term follow up.…”

Section: Discussionsupporting

confidence: 90%

“…Specifically, previous studies have shown that patients with orthotopic neobladder had higher incidence of UTI than patients who received an ileal conduit ( 4 5 ). Although the rate of symptomatic UTI is lower than that of bacteriuria in patients with orthotopic neobladder, patients with febrile UTI are at increased risk of urosepsis ( 6 7 8 ). Moreover, several studies have reported that febrile UTI can adversely affect renal function in patients with ileal neobladder reconstruction ( 9 10 ).…”

Section: Introductionmentioning

confidence: 99%

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Febrile Urinary Tract Infection after Radical Cystectomy and Ileal Neobladder in Patients with Bladder Cancer

Kim

Yoon

et al. 2016

J Korean Med Sci

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Urinary tract infection (UTI) is one of the most common complications after radical cystectomy and orthotopic neobladder reconstruction. This study investigated the incidence and implicated pathogen of febrile UTI after ileal neobladder reconstruction and identify clinical and urodynamic parameters associated with febrile UTI. From January 2001 to May 2015, 236 patients who underwent radical cystectomy and ileal neobladder were included in this study. Fifty-five episodes of febrile UTI were identified in 46 patients (19.4%). The probability of febrile UTI was 17.6% and 19.8% at 6 months and 24 months after surgery, respectively. While, Escherichia coli was the most common implicated pathogen (22/55, 40.0%), Enterococcus spp. were the most common pathogen during the first month after surgery (18/33, 54.5%). In multivariate logistic regression analysis, ureteral stricture was an independent risk factor associated with febrile UTI (OR 5.93, P = 0.023). However, ureteral stricture accounted for only 6 episodes (10.9%, 6/55) of febrile UTI. Most episodes of febrile UTI occurred within 6 months after surgery. Thus, to identify risk factors associated with febrile UTI in the initial postoperative period, we assessed videourodynamics within 6 months after surgery in 38 patients. On videourodyamic examination, vesicoureteral reflux (VUR) was identified in 16 patients (42.1%). The rate of VUR presence in patients who had febrile UTI was not significantly different from those in patients without febrile UTI (50% vs. 39.3%, P = 0.556). Patients with febrile UTI had significantly larger residual urine volume (212.0 ± 193.7 vs. 90.5 ± 148.2, P = 0.048) than those without. E. coli and Enterococcus spp. are common pathogens and ureteral stricture and residual urine are risk factors for UTI after ileal neobladder reconstruction.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Febrile Urinary Tract Infection after Radical Cystectomy and Ileal Neobladder in Patients with Bladder Cancer

Kim

Yoon

et al. 2016

J Korean Med Sci

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“…However, symptomatic urinary tract infection (UTI) is an uncommon complication of neobladder reconstruction in the late postoperative period. In a study of 79 patients with orthotopic neobladder, new events of symptomatic UTI occurred in 36% of cases during the first three postoperative months, compared to only 10% between three and six months and 8% between six and 12 months (12). The common pathogens of symptomatic UTI were Pseudomonas aeruginosa (24%), Escherichia coli (24%) and Klebsiella pneumoniae (22%).…”

Section: Discussionmentioning

confidence: 99%

Inferior Vena Cava Thrombosis Associated with a Distended Ileal Neobladder

et al. 2015

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Venous stasis is generally accepted to be a predisposing factor for venous thrombosis. However, benign causes of inferior vena cava (IVC) obstruction with associated thrombus formation have not been well described. We herein present a case of IVC compression caused by a distended ileal neobladder measuring 2,000 mL in capacity that led to IVC thrombosis. Following transurethral drainage for six weeks and anticoagulation therapy with warfarin for six months, the thrombus completely disappeared. The patient was considered to have a hypercoagulable state resulting from an acute urinary tract infection, a condition that may be associated with an increased risk of thrombosis.

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“…Ondanks de lage druk die wordt nagestreefd door een gedetubulariseerde darmlis te gebruiken, bleek bacteriurie in een neoblaas een potentiële bron van pyelonefritis. Symptomatische urineweginfectie en urosepsis maken, hoe dan ook, een groot deel uit van de complicaties van al dan niet continente urinedeviaties [32]. Ondanks verbetering in de perioperatieve technieken, is er nog altijd sprake van aanzienlijke morbiditeit.…”

Section: Radicale Cystectomie -Indicatie En Alternatievenunclassified

Radicale cystectomie als gouden standaard: open of robotgeassisteerd?

2015

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Trefwoorden radicale cystectomie · robotgeassisteerd · spierinvasief blaascarcinoom Golden standard for radical cystectomy: open or robot assisted?Abstract The open radical cystectomy is considered the golden standard treatment for muscle invasive bladder cancer and recurrent high risk non-muscle invasive bladder cancer. Since 2000 there is an increase in the performance of laparoscopic and robotic assisted cystectomy with or without the creation of an intracorporal performed urine deviation. The results from literature mainly present retrospective studies reflecting comparison with historical open cystectomy series. In combination with few smaller prospective series there is ample evidence for RARC as a safe technique, accompanied with less blood loss and transfusion rates and shorter admission time, compared to the ORC. Concerning the functional and oncological results the RARC seems not inferior to the ORC. In addition, the RARC has a great ergonomic benefit. As a drawback the higher costs for purchase and use of the daVinci™ system can be mentioned. Nowadays, international and national studies are being developed to gain more evidence to show potential difference over the ORC as well as to clarify the concerns about the cost-effectiveness of the RARC Keywords radical cystectomy · robot assisted · muscle invasive bladder cancer Samenvatting De open radicale cystectomie wordt beschouwd als de standaardbehandeling van het spierinvasief blaascarcinoom en bij recidiverend hoogrisico niet-spierinvasief blaascarcinoom. Sinds 2000 wordt de cystectomie steeds meer laparoscopisch en met assistentie van de robot uitgevoerd, al dan niet met een intracorporeel aangelegde urinedeviatie. De resultaten uit de literatuur komen vooral uit retrospectieve studies, waarin de resultaten worden vergeleken met historische open cystectomieseries. In combinatie met de resultaten van enkele kleinere prospectieve series is er aanzienlijk bewijs dat de robotgeassisteerde radicale cystectomie (RARC) een veilige techniek is waarbij minder bloedverlies en bloedtransfusiebehoefte optreedt en patiënten minder lang opgenomen zijn ten opzichte van de open radicale cystectomie (ORC). Ten aanzien van de functionele en oncologische resultaten lijkt de RARC niet onder te doen voor de ORC. Daarbij heeft de RARC een groot ergonomisch voordeel. Een nadeel is dat de aanschaf en het gebruik van een daVinci ™ -systeem gepaard gaan met hogere kosten.Zowel internationaal als nationaal wordt momenteel gewerkt aan prospectieve multicentrische vergelijkende studies om het mogelijke verschil aan te tonen ten opzichte van de ORC op het oncologische en/of functionele vlak, maar daarnaast meer duidelijkheid te verkrijgen ten aanzien van de kosteneffectiviteit van de RARC. dr. A.M. Leliveld ()

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Urinary tract infections in patients with orthotopic neobladder

Cited by 33 publications

References 24 publications

Febrile Urinary Tract Infection after Radical Cystectomy and Ileal Neobladder in Patients with Bladder Cancer

Febrile Urinary Tract Infection after Radical Cystectomy and Ileal Neobladder in Patients with Bladder Cancer

Inferior Vena Cava Thrombosis Associated with a Distended Ileal Neobladder

Radicale cystectomie als gouden standaard: open of robotgeassisteerd?

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