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Purpose <p>Robot-assisted radical cystectomy (RARC) with totally intracorporeal orthotopic neobladder (i-ON) is increasingly used. Functional outcomes in women remain under-investigated due to the limited number of female patients undergoing i-ON.The aim of the present study is to identify predictors of daytime and nighttime continence recovery in female patients undergoing i-ON</p> Methods <p>We retrospectively analysed our IRB-approved single-center database for female patients treated with RARC and i-ON between January 2016 and July 2022. Women receiving sex-sparing approaches were excluded. Continence status was assessed with 3-day voiding diaries. Daytime continence was defined as total dryness (0 g) and nighttime continence as pad wetness ≤50 g. Kaplan–Meier curves and log-rank tests compared recovery; Cox regression identified predictors.</p> Results <p>Thirty-five female patiens were included. Median age was 62 years (IQR 55–66) and BMI 24,5 kg/m2 (IQR 21.5–28.0). High-grade complications (Clavien ≥3) occurred in 11%. Suprapubic specimen extraction was associated with higher daytime continence recovery (logrank p=0,01), while nighttime continence did not differ. On multivariable analysis, transvaginal extraction independently predicted a 65% reduced Accepted manuscriptprobability of daytime continence recovery (HR 0.35, 95% CI 0.14–0.89; p=0.03). No effect was observed for nighttime continence (p=0.86).</p> Conclusions <p>Transvaginal specimen extraction negatively affected daytime but not nighttime continence recovery. Validation in larger, multi-institutional cohorts with longer follow-up is warranted.</p>

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Impact of transvaginal extraction on continence after robotic cystectomy with orthotopic neobladder

  • 期刊论文

  • 发表日期：

    2026年2月25日

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  • Riccardo Mastroianni,
  • Alberto Ragusa,
  • Andrea Iannuzzi,
  • Gabriele Tuderti,
  • Umberto Anceschi,
  • Alfredo Maria Bove,
  • Aldo Brassetti,
  • Simone D’Annunzio,
  • Mariaconsiglia Ferriero,
  • Rocco Simone Flammia,
  • Leonardo Misuraca,
  • Flavia Proietti,
  • Marianna Anselmi,
  • Salvatore Guaglianone,
  • Costantino Leonardo,
  • Rocco Papalia,
  • Giuseppe Simone

摘要

Purpose

Robot-assisted radical cystectomy (RARC) with totally intracorporeal orthotopic neobladder (i-ON) is increasingly used. Functional outcomes in women remain under-investigated due to the limited number of female patients undergoing i-ON.The aim of the present study is to identify predictors of daytime and nighttime continence recovery in female patients undergoing i-ON

Methods

We retrospectively analysed our IRB-approved single-center database for female patients treated with RARC and i-ON between January 2016 and July 2022. Women receiving sex-sparing approaches were excluded. Continence status was assessed with 3-day voiding diaries. Daytime continence was defined as total dryness (0 g) and nighttime continence as pad wetness ≤50 g. Kaplan–Meier curves and log-rank tests compared recovery; Cox regression identified predictors.

Results

Thirty-five female patiens were included. Median age was 62 years (IQR 55–66) and BMI 24,5 kg/m2 (IQR 21.5–28.0). High-grade complications (Clavien ≥3) occurred in 11%. Suprapubic specimen extraction was associated with higher daytime continence recovery (logrank p=0,01), while nighttime continence did not differ. On multivariable analysis, transvaginal extraction independently predicted a 65% reduced Accepted manuscriptprobability of daytime continence recovery (HR 0.35, 95% CI 0.14–0.89; p=0.03). No effect was observed for nighttime continence (p=0.86).

Conclusions

Transvaginal specimen extraction negatively affected daytime but not nighttime continence recovery. Validation in larger, multi-institutional cohorts with longer follow-up is warranted.