MP46-20: Evaluation of urodynamic outcomes and incontinence specific heart-related quality of life in patients treated with robot-assisted radical cystectomy with intracorporeal Y-modified neobladder the Bordeaux Neobladder
Introduction: To present the urodynamic features of our intracorporeal Y-modified neobladder Bordeaux Neobladder and the incontinence specific health-related quality-of-life (HRQoL) outcomes. Methods: We performed a prospective evaluation of a series of 26 patients who underwent robot-assisted radical cystectomy with intracorporeal Y-modified orthotropic neobladder reconstruction called the Bordeaux Neobladder, between September 2018 and November 2020 in a high-volume referral center, operated by the same surgeon. All the patients were managed following a modified ERAS protocol. Three months and 1 year after surgery, consenting patients underwent clinical evaluation and multichannel urodynamics. The incontinence quality of life (I-QoL) questionnaire was used to evaluate HRQoL. Continence was classified into day-time and night-time and clinically defined as the use of zero pads. Results: The mean age at surgery was 65.4 years. The mean follow-up was 27 months. Regarding the operative time, the mean time for proximal bladder reconstruction was 192 minutes. Urodynamic outcomes data were collected in 17/23 patients for early evaluation and in 13 patients for early and dilated testing. 2/17 patients had I-II grade of hydronephrosis on the left kidney. No cases of hyperchloremic acidosis were identified in the blood gas analysis. The continence rate was 58.8% (10/17) for the day and 23.5% (4/17) for the night and the mean postoperative of the quality-of-life score was 103.3. The mean maximum bladder capacity was 430 cc (range 200-553) ant the average compliance was 33.1 ml/cm h2o. The mean post-voiding residue was 100 ml (0-310). The first sensation of bladder fullness was perceived at an average volume of 337 cm³. The mean max flow at 3 months was 15 ml/s and at 1 year was 18 ml/s. The rate of clean intermittent self catheterization was 17,6%. We did not observe significant changes in urodynamic outcomes during follow-up. Concerning the parameters of the storage phase, there was only a significant reduction in the volume of the first sensation of bladder fullness. Conclusions: The initial analysis of both invasive and non-invasive urodynamic parameters shows that the Bordeaux Neobladder has adequate functional characteristics in terms of capacity, post-voiding, residual and compliance. It is associated with a reduced chance of upper urinary tract abnormalities and metabolic complications that improve quality of life. SOURCE OF Funding: None
