Assessment of voiding function of orthotopic neobladders in elderly patients with long-term survival.
OBJECTIVE
To compare the voiding status in elderly patients (aged >or=80 years) with that in younger patients undergoing orthotopic neobladder substitution during long-term survival.


METHODS
The voiding status was assessed in 111 patients (ileal neobladder in 62, ascending colonic neobladder in 14, sigmoid colonic neobladder in 21 and ileocolonic neobladder in 14) who lived for >5 years after radical cystectomy with an orthotopic neobladder, using a self-completed questionnaire and uroflowmetry. According to the age at the time of these assessments, patients were divided into two groups (group 1, <80 years, 94; group 2, >or=80 years, 17). The voiding status was compared between the groups.


RESULTS
In all, 78 patients (92%) in group 1 and 16 (94%) in group 2 were capable of spontaneous voiding. In group 1 and 2, respectively, daytime continence was achieved by 67 (74%) and 12 (75%) patients, but night-time continence was achieved by 54 (60%) and six (38%), although the difference was not statistically significant. In groups 1 and 2, respectively, the median maximum flow rate was 13.3 and 11.7 mL/s and the median postvoid residual urine volume was 19 and 18 mL. The only statistically significant difference was for voiding posture, assessed in men.


CONCLUSIONS
There was no significant difference in voiding status of patients with orthotopic neobladders except for voiding posture between patients aged <80 or carefully selected elderly patients aged >or=80 years during long-term survival. However, night-time continence might be clinically worse in the elderly than in the younger group.
Takenaka
Atsushi
A
Division of Urology, Department of Surgery Related, Kobe University Graduate School of Medicine, Japan. atake@med.kobe-u.ac.jp
Soga
Hideo
H
Terakawa
Tomoaki
T
Kumano
Masafumi
M
Furukawa
Junya
J
Muramaki
Mototsugu
M
Kurahashi
Toshifumi
T
Miyake
Hideaki
H
Tanaka
Kazushi
K
Yamanaka
Nozomu
N
Fujisawa
Masato
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D015653:Cystectomy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053206:Nocturnal Enuresis / Q000503:physiopathology*; D011187:Posture; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D016476:Urinary Reservoirs, Continent / Q000502:physiology*; D014554:Urination / Q000502:physiology*; D014563:Urodynamics / Q000502:physiology