| Salvage prostatectomy with bladder neck closure, continent catheterizable stoma and bladder augmentation: feasibility and patient reported continence outcomes at 32 months De E, Pisters LL, Pettaway CA, Scott S, Westney OL, Division of Urology, Albany Medical Center, 23 Hackett Boulevard, Albany, NY. | |
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MedLine Citation:
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PMID: 18047974 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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PURPOSE: Salvage prostatectomy after radiation therapy is associated with a high rate of urinary incontinence. To avoid this outcome in candidates with pre-existing voiding symptoms, such as frequency, urgency, and urge incontinence, we performed concurrent bladder augmentation with bladder neck closure and a catheterizable stoma. Urinary incontinence and patient satisfaction were evaluated. MATERIALS AND METHODS: Between October 2000 and February 2003, 11 patients underwent salvage prostatectomy with bladder neck closure and ileal augmentation using catheterizable appendicovesicostomy or Monti ileovesicostomy. Self-reported outcome measures included patient questionnaires and the validated Incontinence Symptom Index. RESULTS: The indication for surgery was recurrent adenocarcinoma of the prostate in 10 patients and invasive squamous cell carcinoma of the urethra in 1. All patients underwent prior radiation. Mean +/- SD followup after prostatectomy and reconstruction was 32 +/- 7.5 months. The physician noted that 8 of 11 patients (73%) were dry. Nine of 11 patients (82%) returned the questionnaire. Only 2 of 9 patients (22%) reported using absorbent protection. By self-report and the Incontinence Symptom Index, 4 of 9 patients (44%) reported no leakage and only 3 (33%) had leakage more frequently than once weekly. Three of 11 patients (27%) required stomal revision at an average of 24 +/- 17 months, of whom 2 still reported difficult catheterization. Seven of 9 patients (77%) reported that they would repeat the procedure. CONCLUSIONS: Continent catheterizable bladder augmentation is a technically feasible option for men requiring salvage prostatectomy. The postoperative continence rate is excellent and it appears superior to that in the literature for salvage prostatectomy with vesicourethral anastomosis. |
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Authors:
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Joseph A Smith |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Urologic oncology Volume: 25 ISSN: 1078-1439 ISO Abbreviation: Urol. Oncol. Publication Date: 2007 Nov-Dec |
Date Detail:
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Created Date: 2007-11-30 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9805460 Medline TA: Urol Oncol Country: United States |
Other Details:
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Languages: eng Pagination: 532-3 Citation Subset: IM |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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