Predictors of need for catheterisation and urinary retention after radical cystectomy and orthotopic neobladder in male patients. (20th January 2021)

• Record Type: Journal Article
• Authors: Ghodoussipour, Saum; Ladi Seyedian, Seyedeh Sanam; Jiang, Daniel; Lifton, Jacob; Ahmadi, Hamed; Wayne, Kevin; Miranda, Gus; Cai, Jie; Djaladat, Hooman; Schuckman, Anne; Bhanvadia, Sumeet; Daneshmand, Siamak
• Is Part Of: BJU international. Volume 128:Number 3(2021)
• Page Start: 304
• Page End: 310
• Publication Date: 2021-01-20
• Subjects: cystectomy -- bladder cancer -- urinary diversion -- orthotopic neobladder -- retention -- #BladderCancer -- #blcsm; Genitourinary organs -- Diseases -- Periodicals; Genitourinary organs -- Surgery -- Periodicals; Urology -- Periodicals; 616.6
• DOI: 10.1111/bju.15329
• Languages: English
• ISSNs: 1464-4096

Abstract

Abstract : Objectives: To investigate the prevalence of catheterisation and urinary retention in male patients with bladder cancer after radical cystectomy (RC) and orthotopic neobladder (ONB) and to identify potential predictors. Patients and Methods: Using an Institutional Review Board approved, prospectively maintained bladder cancer database, we collected information using a diversion‐related questionnaire from 299 consecutive male patients with bladder cancer upon postoperative clinic visit. Urinary retention was defined as ≥3 catheterisations/day or a self‐reported inability to void without a catheter. Uni‐ and multivariable Cox regression analysis was performed to identify predictors of catheterisation and urinary retention. Results: Self‐catheterisation was reported in 51 patients (17%), of whom, 22 (7.4% of the total patients) were in retention. Freedom from any catheterisation at 3, 5, and 10 years after RC was 85%, 77%, and 62%, respectively. Freedom from retention at 3, 5, and 10 years after RC was 93%, 88%, and 79%, respectively. Multivariable Cox regression showed that higher body mass index (BMI; ≥27 kg/m 2 ) significantly increased the need for catheterisation (hazard ratio [HR] 2.34, 95% confidence interval [CI] 1.26–4.32) as well as retention (HR 5.20, 95% CI 1.74–15.51). Greater medical comorbidity (Charlson Comorbidity Index score ≥2) correlated with the need for any catheterisation (HR 1.84, 95% CI 1.02–3.3), but not retention. Pathological stage and type of diversion were not significant predictors of the need to catheterise or urinary retention. Conclusion: In males undergoing RC with ONB, retention requiring catheterisation to void is uncommon. Patients with a BMI of ≥27 kg/m 2 are at significantly increased risk of retention and need for self‐catheterisation.