Robot-Assisted Surgery for Bladder Cancer: Long-Term Functional Outcomes

What is it about?

This study evaluates the functional outcomes of patients who underwent robot-assisted radical cystectomy (RARC) with intracorporeal urinary diversion (iNeoB) for muscle-invasive or high-risk non-muscle-invasive bladder cancer. The study found that 78% of patients regained urinary continence (UC) and 47% regained erectile function (EF) at 2 years of follow-up. The study also found that clean intermittent catheterisation (CIC) and the variation in its use during follow-up remain inadequately discussed, and that bowel function (BF) recovery after RARC with iNeoB has not been evaluated in previous studies. The study recommends performing two or more CICs after spontaneous urination daily, and additional CICs if the post-micturition residual is >100 mL. Patients should perform CIC as long as the post-micturition residual is negligible, and pelvic floor muscle training should be started 3 months after surgery.

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Why is it important?

This research is important because it evaluates the functional outcomes of patients who underwent robot-assisted radical cystectomy (RARC) with intracorporal urinary diversion (iNeoB) for muscle-invasive bladder cancer (MIBC) and high-risk non-MIBC (NMIBC). The study provides valuable information on the recovery of urinary continence (UC), erectile function (EF), and bowel function (BF) over time, which are crucial aspects of patient quality of life. Key Takeaways: 1. The study evaluates functional outcomes of one of the largest single-center series of patients undergoing RARC with iNeoB. 2. 78% and 47% of patients regained UC and EF at 2 years of follow-up, respectively. 3. Most patients reached UC and EF after 12 and 24 months, respectively. 4. The study is the first to assess the time needed to regain EF after RARC with iNeoB. 5. The study also evaluates daily pads and CICs use over time, with the 2-year rate of CIC being 13%. 6. The study is the first to evaluate BF recovery after RARC with iNeoB, with all patients reporting altered BF after surgery and BF recovery mostly attained after ~1 year.