Mastroianni Riccardo, Iannuzzi Andrea, Ragusa Alberto, Tuderti Gabriele, Anceschi Umberto, Bove Alfredo Maria, Brassetti Aldo, D'Annunzio Simone, Ferriero Mariaconsiglia, Misuraca Leonardo, Guaglianone Salvatore, Papalia Rocco, Simone Giuseppe
Uro-Oncology Program, IRCCS Regina Elena National Cancer Institute, Rome, Italy.
Research Unit of Urology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy.
World J Urol. 2025 Sep 10;43(1):548. doi: 10.1007/s00345-025-05930-9.
We aimed to evaluate the impact of day- and night-time pad wetness on 2yrs-QoL after Radical Cystectomy (RC) with Orthotopic Neobladder (ON) from a Randomized Controlled Trial (RCT) aimed at comparing open RC (ORC) and Robot-Assisted RC (RARC) with intracorporeal (i) ON.
Between January 2018 and September 2020, 116 patients were enrolled. Data from self-assessed questionnaires (EORTC-QLQ-C30 and QLQ-BLM30) were collected. Unmodified HRQoL was defined as a 2yrs Global Health status/QoL increase ≥ 0 (ΔQL ≥ 0) from baseline. Quantitative analysis of continence status was evaluated through 3-day voiding diaries. We previously defined day-time continence as "complete dryness" (0gr pad wetness) and night-time continence as pad wetness ≤ 50gr.
Out of 116 patients enrolled, 88 received ON, and 71 with a minimum 2yrs follow-up were included. Quantitative analysis of day- and night-time urinary continence are reported. Particularly, 44 patients (62%) were completely dry during the day, while 40 patients (57%) experienced night-time pad wetness ≤ 50gr. However, a day pad wetness > 0gr significantly impact on 2yrs unmodified Global Health Status (p = 0.029), while only a night-time pad wetness ≥ 500gr significantly impacts on 2yrs unmodified Global Health Status (p = 0.005).
This study strengthens the need for a strict definition of day-time urinary continence after RC and ON, confirming complete dryness as a main driver of patients' HRQoL. Conversely, nigh-time continence status seems to play a negligible role on subjectively assessed HRQoL.
我们旨在通过一项随机对照试验（RCT）评估白天和夜间尿垫湿润对根治性膀胱切除术（RC）并原位新膀胱（ON）后2年生活质量（QoL）的影响，该试验旨在比较开放根治性膀胱切除术（ORC）和机器人辅助根治性膀胱切除术（RARC）并体内（i）原位新膀胱。
2018年1月至2020年9月期间，招募了116名患者。收集了自我评估问卷（EORTC-QLQ-C30和QLQ-BLM30）的数据。未改变的健康相关生活质量定义为自基线起2年全球健康状况/生活质量增加≥0（ΔQL≥0）。通过3天排尿日记对控尿状态进行定量分析。我们之前将白天控尿定义为“完全干燥”（尿垫湿润0克），夜间控尿定义为尿垫湿润≤50克。
在116名入组患者中，88名接受了原位新膀胱手术，71名接受了至少2年随访并被纳入研究。报告了白天和夜间尿失禁的定量分析。具体而言，44名患者（62%）白天完全干燥，而40名患者（57%）夜间尿垫湿润≤50克。然而，白天尿垫湿润>0克对2年未改变的全球健康状况有显著影响（p = 0.029），而只有夜间尿垫湿润≥500克对2年未改变的全球健康状况有显著影响（p = 0.005）。
本研究强化了对根治性膀胱切除术后白天尿失禁进行严格定义的必要性，并确认完全干燥是患者健康相关生活质量的主要驱动因素。相反，夜间控尿状态在主观评估的健康相关生活质量中似乎起的作用微不足道。
